Healthcare Provider Details

I. General information

NPI: 1558003939
Provider Name (Legal Business Name): THE CARTER CONSORTIUM CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6022 JEFF DR
MECHANICSVILLE VA
23111-4528
US

IV. Provider business mailing address

8005C CREIGHTON PKWY # 724
MECHANICSVILLE VA
23111-4593
US

V. Phone/Fax

Practice location:
  • Phone: 703-517-1866
  • Fax: 703-770-6082
Mailing address:
  • Phone: 703-517-1866
  • Fax: 703-770-6082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name: DR. BENEALIA CARTER
Title or Position: CEO
Credential: LPC, LCPC, LMHC, NCC
Phone: 703-770-8092