Basic Information
| Provider Information | |||||||||
| NPI: | 1316662117 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | JERI | ||||||||
| MiddleName: | GRIER | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, LMHCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7409 DERBY MEADOWS CT | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282167758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9808333606 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5108 REAGAN DR STE 14 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282061395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043328787 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2022 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | A18048 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.