Healthcare Provider Details

I. General information

NPI: 1184437220
Provider Name (Legal Business Name): MAEGAN CARTER LMHC
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 02/02/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 S PACHECO ST STE 500
SANTA FE NM
87505-3994
US

IV. Provider business mailing address

2055 S PACHECO ST STE 500
SANTA FE NM
87505-3994
US

V. Phone/Fax

Practice location:
  • Phone: 505-702-8112
  • Fax: 505-355-2611
Mailing address:
  • Phone: 505-702-8112
  • Fax: 505-355-2611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2025-0054
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: