Active NPI
Alfred Ball Carter IV, MA
- Professional Counselor
- Kennesaw, GA
National Provider Identifier
1285702779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 005248
- Practice address
- 1815 Old 41 Hwy NW
Suite 110
Kennesaw, GA 30152-4420 - Phone
- (678) 468-9103
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 005264 | GA | |
| Professional Counselor | 101YP2500X | 005248 | GA | Primary |
Addresses
Primary practice location
1815 Old 41 Hwy NW
Suite 110
Kennesaw, GA 30152-4420
Mailing address
2618 Marleigh Farm Rd NW
Kennesaw, GA 30152-6520
Phone (404) 895-9984
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005264 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1285702779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2618 MARLEIGH FARM RD NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301526520",
"telephone_number": "404-895-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 OLD 41 HWY NW",
"address_2": "SUITE 110",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301524420",
"telephone_number": "678-468-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "ALFRED",
"middle_name": "BALL",
"name_prefix": "Mr.",
"name_suffix": "IV",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "005264",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "005248",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.