Provider Demographics
NPI:1578453635
Name:CARTER, DEJANEARA-JEANNETTE (LMSW)
Entity type:Individual
Prefix:
First Name:DEJANEARA-JEANNETTE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5531 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2851
Mailing Address - Country:US
Mailing Address - Phone:209-681-7123
Mailing Address - Fax:
Practice Address - Street 1:12401 E 43RD ST S STE 121
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-5925
Practice Address - Country:US
Practice Address - Phone:816-500-6436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230421151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical