Provider Demographics
NPI:1962542654
Name:CARTER, SARA N (MS, LPCC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:N
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:N
Other - Last Name:DAVENPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 ERLANGER RD
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1728
Mailing Address - Country:US
Mailing Address - Phone:859-341-5782
Mailing Address - Fax:859-341-5783
Practice Address - Street 1:34 ERLANGER RD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1728
Practice Address - Country:US
Practice Address - Phone:859-341-5782
Practice Address - Fax:859-341-5783
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0508101YP2500X
KYKY-1139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY3383Medicare ID - Type UnspecifiedMEDICARE