Provider Demographics
NPI:1063621282
Name:CARTER, DENISE M
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W.47 TH PLACE
Mailing Address - Street 2:
Mailing Address - City:LOSANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037
Mailing Address - Country:US
Mailing Address - Phone:323-234-2937
Mailing Address - Fax:
Practice Address - Street 1:2931 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-5110
Practice Address - Country:US
Practice Address - Phone:323-750-8040
Practice Address - Fax:323-750-8075
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)