Basic Information
| Provider Information | |||||||||
| NPI: | 1659881332 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BLACK | ||||||||
| FirstName: | TERI | ||||||||
| MiddleName: | CARTER | ||||||||
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| Credential: | LPCA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 CHADWICK SQUARE CT | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287393201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286974187 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2270 SUGARLOAF RD | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287928854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286974600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | A13342 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.