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General NPI Number Information
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NPI Number | 1578453635
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Entity Type | Individual
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Provider Name | DEJANEARA-JEANNETTE CARTER LMSW
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Gender | Female
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 12401 E 43RD ST S STE 121
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City | INDEPENDENCE
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State | MO
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Zip | 64055-5925
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Country | US
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Telephone | 816-500-6436
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Fax |
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Provider Business Mailing Address
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Address Line | 5531 VIRGINIA AVE
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City | KANSAS CITY
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State | MO
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Zip | 64110-2851
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Country | US
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Telephone | 209-681-7123
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2023042115
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License Number State | MO
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