Healthcare Provider Details

I. General information

NPI: 1174464614
Provider Name (Legal Business Name): CAREN CARTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 HERITAGE VILLAGE PLZ UNIT 101
GAINESVILLE VA
20155-3091
US

IV. Provider business mailing address

13901 GALLERY WAY
GAINESVILLE VA
20155-5909
US

V. Phone/Fax

Practice location:
  • Phone: 571-261-1921
  • Fax: 571-261-1170
Mailing address:
  • Phone: 703-517-6528
  • Fax: 703-517-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701016061
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: