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NPI Code Detail

MEDICARE: JEFFREY HUDDLESTON CARTER LPC

MEDICARE: JEFFREY HUDDLESTON CARTER LPC
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
1101YP2500XProfessional CounselorPC006745PA
2101YP2500XProfessional Counselor71369TX
3101YA0400XAddiction (Substance Use Disorder) Counselor8233PA
4101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1528307923
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY HUDDLESTON CARTER LPC
Provider Business Mailing Address
First Line : 12001 HERB BROOKS DR
Second Line :
City : AUSTIN
State : TX
Zip : 78748-3536
Country : US
Telephone Number : 610-310-5622
Fax Number :
Provider Business Practice Location Address
First Line : 6448 E HWY 290 STE F108
Second Line :
City : AUSTIN
State : TX
Zip : 78723-1042
Country : US
Telephone Number : 610-310-5622
Fax Number : 610-310-5622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2013
Last Update Date : 11/25/2021

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