Provider Demographics
NPI:1194779868
Name:CARTER, DANA M (MSW/LCSW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:CARTER
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 E WALNUT ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4505
Mailing Address - Country:US
Mailing Address - Phone:573-356-8111
Mailing Address - Fax:
Practice Address - Street 1:19 E WALNUT ST
Practice Address - Street 2:SUITE G
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4505
Practice Address - Country:US
Practice Address - Phone:573-356-8111
Practice Address - Fax:573-634-4010
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020300441041C0700X, 101YA0400X, 101YM0800X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool