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General NPI Number Information
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NPI Number | 1952479941
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Entity Type | Individual
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Provider Name | KIMBERLY S. CARTER LPC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 1527 HEMPHILL ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4706
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Country | US
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Telephone | 817-569-5911
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Fax | 817-569-5998
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Provider Business Mailing Address
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Address Line | 1125 PARK GLN
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City | CROWLEY
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State | TX
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Zip | 76036-3411
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Country | US
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Telephone | 870-941-6002
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Fax | 817-569-5998
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A0611079
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 64063
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License Number State | TX
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