Provider Demographics
NPI:1285702779
Name:CARTER, ALFRED BALL IV (MA)
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:BALL
Last Name:CARTER
Suffix:IV
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 MARLEIGH FARM RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-6520
Mailing Address - Country:US
Mailing Address - Phone:404-895-9984
Mailing Address - Fax:
Practice Address - Street 1:1815 OLD 41 HWY NW
Practice Address - Street 2:SUITE 110
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4420
Practice Address - Country:US
Practice Address - Phone:678-468-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005264101YP2500X
GA005248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional