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General NPI Number Information
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NPI Number | 1952093304
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Entity Type | Individual
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Provider Name | GLENDA CARTER LPC
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Gender | Female
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 6726 TARA BLVD APT 15G
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City | JONESBORO
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State | GA
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Zip | 30236-1427
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Country | US
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Telephone | 404-510-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 255 N MAIN ST UNIT 1355
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City | JONESBORO
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State | GA
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Zip | 30236-3298
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Country | US
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Telephone | 404-510-9660
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC013928
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License Number State | GA
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