Provider Demographics
NPI:1285129742
Name:CARTER, WILLIAM HYATT
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HYATT
Last Name:CARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-1162
Mailing Address - Country:US
Mailing Address - Phone:231-597-9235
Mailing Address - Fax:
Practice Address - Street 1:2236 E MITCHELL RD UNIT 5
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-9604
Practice Address - Country:US
Practice Address - Phone:231-347-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)