Provider Demographics
NPI:1932137403
Name:CARTER, SANDY A (MA LPC-S)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:A
Last Name:CARTER
Suffix:
Gender:F
Credentials:MA LPC-S
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC-S
Mailing Address - Street 1:PO BOX 786
Mailing Address - Street 2:
Mailing Address - City:GOODRICH
Mailing Address - State:TX
Mailing Address - Zip Code:77335-0786
Mailing Address - Country:US
Mailing Address - Phone:281-610-0303
Mailing Address - Fax:888-845-3240
Practice Address - Street 1:33130 MAGNOLIA CIR STE 10
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3277
Practice Address - Country:US
Practice Address - Phone:281-610-0303
Practice Address - Fax:888-845-3240
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6309LCOtherBCBSTX PIN
TX163381002Medicaid