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General NPI Number Information
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NPI Number | 1972954576
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Entity Type | Individual
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Provider Name | JOANNA CARTER M.ED, CNA, MA, PRS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 204 N MAIN ST SECOND FLOOR
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City | BOWLING GREEN
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State | VA
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Zip | 22427-9416
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Country | US
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Telephone | 202-997-5738
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Fax | 804-729-3529
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Provider Business Mailing Address
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Address Line | PO BOX 613
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City | BOWLING GREEN
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State | VA
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Zip | 22427-0613
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Country | US
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Telephone | 202-769-2032
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 0180865658
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 0181969996
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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