MEDICARE: ALEXIUS 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	101YM0800X	Mental Health Counselor	SW17617	FL
2	1041C0700X	Clinical Social Worker	125329	CA
3	1041C0700X	Clinical Social Worker	SW17617	FL

General Provider Information

NPI Number	:	1588826085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIUS CARTER LCSW

Provider Business Mailing Address
First Line	:	907 TORREY PINE DR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4347
Country	:	US
Telephone Number	:	407-416-3533
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 TORREY PINE DR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4347
Country	:	US
Telephone Number	:	407-416-3533
Fax Number	:

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

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	09/26/2024

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