Provider Demographics
NPI:1366172298
Name:CARTER BRANLEY COUNSELING & WELLNESS, LLC
Entity type:Organization
Organization Name:CARTER BRANLEY COUNSELING & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARTER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:941-855-0500
Mailing Address - Street 1:1735 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:VT
Mailing Address - Zip Code:05445-9508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1735 LAKE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:VT
Practice Address - Zip Code:05445-9508
Practice Address - Country:US
Practice Address - Phone:802-425-6423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)