MEDICARE: MS. LATOYA CHERRELL CARTER M.ED, 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
1	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator
3	101YP2500X	Professional Counselor	80191	TX

General Provider Information

NPI Number	:	1669513347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LATOYA CHERRELL CARTER M.ED, LPC

Provider Business Mailing Address
First Line	:	945 CARTHAGE WAY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-6552
Country	:	US
Telephone Number	:	615-720-5128
Fax Number	:

Provider Business Practice Location Address
First Line	:	1814 8TH AVE # B201
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110
Country	:	US
Telephone Number	:	817-899-0306
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/16/2018

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