MEDICARE: CARTER COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1043977259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTER COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	2610 W PEBBLE CREEK LN
Second Line	:
City	:	LEHI
State	:	UT
Zip	:	84043-4903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7069 S HIGHLAND DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3724
Country	:	US
Telephone Number	:	801-244-2021
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BOBBI CARTER
Credential	:
Telephone Number	:	801-244-2021

Provider Enumeration Date	:	11/22/2021
Last Update Date	:	11/22/2021

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