Provider Demographics
NPI:1215952817
Name:CARTER, LEONARD J (LPC)
Entity type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:J
Last Name:CARTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 JEFFERSON PARK AVENUE
Mailing Address - Street 2:SUITE 608
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-243-5152
Mailing Address - Fax:434-243-6693
Practice Address - Street 1:1224 JEFFERSON PARK AVENUE
Practice Address - Street 2:SUITE 608
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903
Practice Address - Country:US
Practice Address - Phone:434-243-5152
Practice Address - Fax:434-243-6693
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health