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NPI Code Detail

MEDICARE: MS. KIMBERLY S. CARTER LPC

MEDICARE: MS. KIMBERLY S. 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
1101YM0800XMental Health CounselorA0611079AR
2101YP2500XProfessional Counselor64063TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18744LLOTHERBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952479941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY S. CARTER LPC
Provider Business Mailing Address
First Line : 1125 PARK GLN
Second Line :
City : CROWLEY
State : TX
Zip : 76036-3411
Country : US
Telephone Number : 870-941-6002
Fax Number : 817-569-5998
Provider Business Practice Location Address
First Line : 1527 HEMPHILL ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4706
Country : US
Telephone Number : 817-569-5911
Fax Number : 817-569-5998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 12/03/2012

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