Provider Demographics
NPI:1699141234
Name:CARTER, KATHERINE NICOLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:NICOLE
Last Name:CARTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:NICOLE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:6051 N BROOKLINE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4286
Mailing Address - Country:US
Mailing Address - Phone:405-821-5121
Mailing Address - Fax:405-607-4340
Practice Address - Street 1:6051 N BROOKLINE AVE STE 108
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4286
Practice Address - Country:US
Practice Address - Phone:405-821-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health