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General NPI Number Information
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NPI Number | 1366974883
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Entity Type | Individual
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Provider Name | JESSICA NICOLE CARTER LMFTA
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Gender | Female
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 3725 NATIONAL DR #220
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City | RALEIGH
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State | NC
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Zip | 27612-4066
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Country | US
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Telephone | 919-781-8370
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Fax | 919-781-2266
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Provider Business Mailing Address
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Address Line | 3117 MARSHLANE WAY
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City | RALEIGH
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State | NC
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Zip | 27610
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Country | US
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Telephone | 919-671-3967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12016A
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 07366
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A12911
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License Number State | NC
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