Provider Demographics
NPI:1316662117
Name:CARTER, JERI GRIER (MS, LMHCA)
Entity type:Individual
Prefix:MRS
First Name:JERI
Middle Name:GRIER
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 DERBY MEADOWS CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-7758
Mailing Address - Country:US
Mailing Address - Phone:980-833-3606
Mailing Address - Fax:
Practice Address - Street 1:11601 REAMES RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7662
Practice Address - Country:US
Practice Address - Phone:980-833-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional