Provider Demographics
NPI:1104545615
Name:CARTER, KRISTI LYNN (PLPC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:CARTER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 TASSO LOOP
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-7928
Mailing Address - Country:US
Mailing Address - Phone:337-305-3026
Mailing Address - Fax:
Practice Address - Street 1:4640 W CONGRESS ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6622
Practice Address - Country:US
Practice Address - Phone:337-210-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health