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General NPI Number Information
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NPI Number | 1164010369
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Entity Type | Organization
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Legal Business Name | FOUR C'S DEVELOPMENT
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 1004 EDGEWOOD WAY
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City | LAWRENCEBURG
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State | KY
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Zip | 40342-1641
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Country | US
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Telephone | 859-582-9606
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Fax |
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Provider Business Mailing Address
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Address Line | 1047 HIGHVIEW DR
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City | LAWRENCEBURG
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State | KY
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Zip | 40342-9703
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Country | US
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Telephone | 859-582-9606
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CRISTY R CARTER
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Credential | LPCC-S
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Telephone | 859-582-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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