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General NPI Number Information
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NPI Number | 1689714149
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Entity Type | Individual
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Provider Name | MELANIE RENEE CARTER-HACK LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 901 ATKINSON HILL AVENUE
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City | BARDSTOWN
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State | KY
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Zip | 40004
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Country | US
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Telephone | 502-348-9048
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Fax | 502-349-6450
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Provider Business Mailing Address
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Address Line | 4951 N LONG GROVE RD
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City | CECILIA
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State | KY
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Zip | 42724-9543
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Country | US
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Telephone | 270-427-0895
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Fax | 502-349-6450
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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 | 0646
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License Number State | KY
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