Individual
H. ELLIS CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
300 MEDICAL DR, SUITE 705 ELLIS CARPENTER, LMFT, LAGRANGE, GA 30240-4155
(706) 885-0111
(706) 885-0607
Mailing address
300 MEDICAL DR, SUITE 705, LAGRANGE, GA 30240-4130
(706) 885-0111
(706) 885-0607
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
710
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
793918807A
—
GA
Enumeration date
04/26/2006
Last updated
05/16/2008
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