Provider Demographics
NPI:1144681164
Name:CARTER, QUAMINA (LMHC, LCAC)
Entity type:Individual
Prefix:
First Name:QUAMINA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LMHC, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10068 PINE GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46234-9070
Mailing Address - Country:US
Mailing Address - Phone:317-840-3638
Mailing Address - Fax:
Practice Address - Street 1:4057 VINCENNES RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3008
Practice Address - Country:US
Practice Address - Phone:317-840-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001459A101YA0400X
IN39002357A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)