Provider Demographics
NPI:1386757227
Name:CARTER, CHRIS GEORGE (BA SW)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:GEORGE
Last Name:CARTER
Suffix:
Gender:M
Credentials:BA SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W. MEMORIAL DR.
Mailing Address - Street 2:
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931
Mailing Address - Country:US
Mailing Address - Phone:906-482-9400
Mailing Address - Fax:906-483-0269
Practice Address - Street 1:901 W. MEMORIAL DR.
Practice Address - Street 2:
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931
Practice Address - Country:US
Practice Address - Phone:906-482-9400
Practice Address - Fax:906-483-0269
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020828701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical