Basic Information
| Provider Information | |||||||||
| NPI: | 1285236166 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | DANIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8948 KEAVY RD | ||||||||
| Address2: | |||||||||
| City: | LONDON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407448822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064385586 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1203 AMERICAN GREETING CARD RD | ||||||||
| Address2: | |||||||||
| City: | CORBIN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 407014811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6065287010 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2020 | ||||||||
| LastUpdateDate: | 11/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.