Provider Demographics
NPI:1154186369
Name:CARTER, TANETTA HIGHTOWER (LPC)
Entity type:Individual
Prefix:
First Name:TANETTA
Middle Name:HIGHTOWER
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 FAIRBURN RD SW UNIT 310874
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31131-2609
Mailing Address - Country:US
Mailing Address - Phone:404-919-6564
Mailing Address - Fax:
Practice Address - Street 1:5835 CAMPBELLTON RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8013
Practice Address - Country:US
Practice Address - Phone:404-919-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X, 103TE1100X, 174H00000X
GALPC014444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No174H00000XOther Service ProvidersHealth Educator