Provider Demographics
NPI:1215155965
Name:CARTER, MARILYN J (LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:J
Last Name:CARTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1272
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-4272
Mailing Address - Country:US
Mailing Address - Phone:270-618-0342
Mailing Address - Fax:
Practice Address - Street 1:217 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-1122
Practice Address - Country:US
Practice Address - Phone:270-618-0342
Practice Address - Fax:270-239-9356
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0580106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist