Provider Demographics
NPI:1467088575
Name:CARTER, CAROL (BCBBA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:BCBBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 W GRAPEVINE MILLS CIR # 555
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2096
Mailing Address - Country:US
Mailing Address - Phone:972-878-8776
Mailing Address - Fax:
Practice Address - Street 1:2451 W GRAPEVINE MILLS CIR # 555
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-2096
Practice Address - Country:US
Practice Address - Phone:972-878-8776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2025-08-27
Deactivation Date:2025-08-11
Deactivation Code:
Reactivation Date:2025-08-27
Provider Licenses
StateLicense IDTaxonomies
TX6721103K00000X
TX3246106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty