Healthcare Provider Details

I. General information

NPI: 1013544071
Provider Name (Legal Business Name): LEEALLIE PEARL CARTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 TABERNACLE RD
BLACK MOUNTAIN NC
28711-2526
US

IV. Provider business mailing address

201 TABERNACLE RD
BLACK MOUNTAIN NC
28711-2526
US

V. Phone/Fax

Practice location:
  • Phone: 828-257-6200
  • Fax: 828-257-6300
Mailing address:
  • Phone: 828-257-6200
  • Fax: 828-257-6300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2022-01496
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: