Healthcare Provider Details

I. General information

NPI: 1699689240
Provider Name (Legal Business Name): KARIS N CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 CENTERVILLE BUSINESS PKWY STE 310
DAYTON OH
45459-2697
US

IV. Provider business mailing address

631 WILMINGTON AVE
DAYTON OH
45420-1847
US

V. Phone/Fax

Practice location:
  • Phone: 855-640-7183
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2608696
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: