Provider Demographics
NPI:1437996816
Name:CARTER, CHRISTIAN
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:CARTER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:REN
Other - Middle Name:
Other - Last Name:FIORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:362 KENLEE CIR APT 3
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-7267
Mailing Address - Country:US
Mailing Address - Phone:931-436-6678
Mailing Address - Fax:
Practice Address - Street 1:958 COLLETT AVE # 315
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2309
Practice Address - Country:US
Practice Address - Phone:615-502-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor