MEDICARE: SHARLA CARPENTER

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	106H00000X	Marriage & Family Therapist	354	KS
2	106H00000X	Marriage & Family Therapist	201880	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497855001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLA CARPENTER

Provider Business Mailing Address
First Line	:	3840 HULEN ST
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-7277
Country	:	US
Telephone Number	:	817-569-4523
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 HULEN ST
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76107-7277
Country	:	US
Telephone Number	:	817-569-4523
Fax Number	:

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/24/2013

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Directions to “ SHARLA CARPENTER ” Practice Location

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