Individual
MARTHA SUSAN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 863-8511
(612) 863-8516
Mailing address
2550 UNIVERSITY AVENUE WEST, SUITE 229N, ST PAUL, MN 55114
(651) 645-3115
(654) 645-2752
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
15337
MN
1041C0700X
Clinical Social Worker
Primary
15337
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176648100
—
MN
01
—
200RICA
BCBS OF MN
—
Enumeration date
12/28/2005
Last updated
01/04/2018
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