Healthcare Provider Details

I. General information

NPI: 1548686454
Provider Name (Legal Business Name): ERIN MARIE CARTER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2014
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 AURORA AVE STE 305E
URBANDALE IA
50322-2863
US

IV. Provider business mailing address

1817 N 48TH ST
MILWAUKEE WI
53208-1714
US

V. Phone/Fax

Practice location:
  • Phone: 515-724-8920
  • Fax: 712-545-2900
Mailing address:
  • Phone: 573-424-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number083444
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5017-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: