Individual provider Active NPI

David E. Carter, LCSW

  • Clinical Social Worker
  • Corvallis, OR
National Provider Identifier
1447402490
Registry record updated Aug 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4695 Issued in OR
Practice address
2065 NW Grant Ave
Suite C
Corvallis, OR 97330-4366
Phone
(541) 224-6553
Fax
(541) 758-2277
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L4695 OR Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

2065 NW Grant Ave
Suite C
Corvallis, OR 97330-4366

Mailing address

2065 NW Grant Ave
Suite C
Corvallis, OR 97330-4366
Phone (541) 224-6553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L4695ORMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1447402490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 NW GRANT AVE",
            "address_2": "SUITE C",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304366",
            "telephone_number": "541-224-6553",
            "fax_number": "541-758-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 NW GRANT AVE",
            "address_2": "SUITE C",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304366",
            "telephone_number": "541-224-6553",
            "fax_number": "541-758-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DAVID",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4695",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.