Healthcare Provider Details

I. General information

NPI: 1497964258
Provider Name (Legal Business Name): TONI RACHELL CARTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 HARKEE
ST. LOUIS MO
63031
US

IV. Provider business mailing address

10214 HOBKIRK DR
SAINT LOUIS MO
63137-3744
US

V. Phone/Fax

Practice location:
  • Phone: 314-831-1533
  • Fax: 314-831-1391
Mailing address:
  • Phone: 314-869-2035
  • Fax: 314-869-4762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004004
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: