Provider Demographics
NPI:1194354449
Name:CARTER, DENISE ELISABETH (LMHC)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ELISABETH
Last Name:CARTER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 S HIGHWAY 77 STE 110330
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4616
Mailing Address - Country:US
Mailing Address - Phone:850-866-9767
Mailing Address - Fax:
Practice Address - Street 1:2310 S HIGHWAY 77 STE 110330
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4616
Practice Address - Country:US
Practice Address - Phone:850-866-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health