Provider Demographics
NPI:1063936821
Name:CARTER, KELSIE (LAPC)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:
Other - Last Name:PAULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 CENTRAL AVE N STE 203
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-2915
Mailing Address - Country:US
Mailing Address - Phone:701-490-3281
Mailing Address - Fax:701-490-3283
Practice Address - Street 1:323 CENTRAL AVE N STE 203
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-2915
Practice Address - Country:US
Practice Address - Phone:701-490-3281
Practice Address - Fax:701-490-3283
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND910-8-1-17A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional