Provider Demographics
NPI:1053896811
Name:CARTER, CHELSEA E
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:E
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 RALEIGH CT # A
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-1945
Mailing Address - Country:US
Mailing Address - Phone:615-519-1160
Mailing Address - Fax:615-876-8522
Practice Address - Street 1:2284 RALEIGH CT # A
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-1945
Practice Address - Country:US
Practice Address - Phone:615-519-1160
Practice Address - Fax:615-876-8522
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty