MEDICARE: STACEY LAUREN CARTER MS, NCC, LMHC

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	101YM0800X	Mental Health Counselor	39005421A	IN

General Provider Information

NPI Number	:	1275320780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY LAUREN CARTER MS, NCC, LMHC

Provider Business Mailing Address
First Line	:	28208 STATE ROUTE 1 STE 101
Second Line	:
City	:	WEST HARRISON
State	:	IN
Zip	:	47060-9410
Country	:	US
Telephone Number	:	812-576-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	28208 STATE ROUTE 1
Second Line	:
City	:	WEST HARRISON
State	:	IN
Zip	:	47060-9686
Country	:	US
Telephone Number	:	812-576-1600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	04/21/2025

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