Healthcare Provider Details

I. General information

NPI: 1942698816
Provider Name (Legal Business Name): KRISTI CARTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTI C NEAL LCSW

II. Dates (important events)

Enumeration Date: 12/31/2014
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 KENNY DAVIS BLVD
MONTICELLO KY
42633-9479
US

IV. Provider business mailing address

PO BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 844-435-0900
  • Fax: 270-858-4601
Mailing address:
  • Phone: 270-864-1472
  • Fax: 270-864-1693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number252251
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: