Provider Demographics
NPI:1184758021
Name:HUNTER, CARRIE A (MA, MDIV)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:A
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MA, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1027
Mailing Address - Country:US
Mailing Address - Phone:502-558-1102
Mailing Address - Fax:
Practice Address - Street 1:125 CHENOWETH LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2641
Practice Address - Country:US
Practice Address - Phone:502-897-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist