MEDICARE: JEFFREY MONTAY CARTER

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	101YS0200X	School Counselor	PGP-0673393

General Provider Information

NPI Number	:	1629925342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY MONTAY CARTER

Provider Business Mailing Address
First Line	:	12706 SUMMERHOUSE LN
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-3287
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 MOSBY ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-5005
Country	:	US
Telephone Number	:	804-780-8011
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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