Provider Demographics
NPI:1316712920
Name:TAYLOR CARTER, CATHY GAIL (PR)
Entity type:Individual
Prefix:PROF
First Name:CATHY
Middle Name:GAIL
Last Name:TAYLOR CARTER
Suffix:
Gender:F
Credentials:PR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 FERNWOOD CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-6203
Mailing Address - Country:US
Mailing Address - Phone:423-839-0953
Mailing Address - Fax:
Practice Address - Street 1:1805 FERNWOOD CHURCH RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-6203
Practice Address - Country:US
Practice Address - Phone:423-839-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty