MEDICARE: MR. DONALD L. CARTER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0171	OK

General Provider Information

NPI Number	:	1225275464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD L. CARTER LCSW

Provider Business Mailing Address
First Line	:	701 MARKET DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-8132
Country	:	US
Telephone Number	:	405-951-3817
Fax Number	:	405-951-3916

Provider Business Practice Location Address
First Line	:	701 MARKET DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-8132
Country	:	US
Telephone Number	:	405-951-3817
Fax Number	:	405-951-3916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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