Basic Information
Provider Information
NPI: 1003286691
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARTER
FirstName: ALYSSA
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1600 N LORRAINE ST STE 202
Address2:  
City: HUTCHINSON
State: KS
PostalCode: 675015600
CountryCode: US
TelephoneNumber: 6206637595
FaxNumber: 6205135098
Practice Location
Address1: 1600 N LORRAINE ST
Address2: STE 202
City: HUTCHINSON
State: KS
PostalCode: 675015670
CountryCode: US
TelephoneNumber: 6206637595
FaxNumber: 6206635263
Other Information
ProviderEnumerationDate: 09/25/2015
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X2756KSY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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