Provider Demographics
NPI:1194529370
Name:CARTER, SAMANTHA SHEA (LCSW-A)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SHEA
Last Name:CARTER
Suffix:
Gender:
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7830 N POINT BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3261
Mailing Address - Country:US
Mailing Address - Phone:336-896-0904
Mailing Address - Fax:336-896-1402
Practice Address - Street 1:7830 N POINT BLVD STE 201
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3261
Practice Address - Country:US
Practice Address - Phone:336-896-0904
Practice Address - Fax:336-896-1402
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P0173731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical