Provider Demographics
NPI:1255748406
Name:CARTER, DARYL (MS, NCC)
Entity type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:CARTER
Suffix:
Gender:M
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 HORRIGAN CT
Mailing Address - Street 2:APT B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5016
Mailing Address - Country:US
Mailing Address - Phone:804-304-8608
Mailing Address - Fax:
Practice Address - Street 1:9568 KINGS CHARTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-0078
Practice Address - Country:US
Practice Address - Phone:804-496-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health