Healthcare Provider Details

I. General information

NPI: 1407489669
Provider Name (Legal Business Name): COURTNEY CARTER MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2020
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9177 CUT BANK WAY
COLORADO SPRINGS CO
80908-2708
US

IV. Provider business mailing address

9177 CUT BANK WAY
COLORADO SPRINGS CO
80908-2708
US

V. Phone/Fax

Practice location:
  • Phone: 720-998-7023
  • Fax:
Mailing address:
  • Phone: 720-998-5723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: