Healthcare Provider Details

I. General information

NPI: 1982913745
Provider Name (Legal Business Name): CYNAE RASHEL CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 SHARKEY WAY # 200
LEXINGTON KY
40511-2028
US

IV. Provider business mailing address

1718 SHARKEY WAY # 200
LEXINGTON KY
40511-2028
US

V. Phone/Fax

Practice location:
  • Phone: 317-659-0002
  • Fax:
Mailing address:
  • Phone: 317-659-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number255663
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: