Provider Demographics
NPI:1881084945
Name:CARPENTER, NATHAN DAVID (LMFT)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:DAVID
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BRYON AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4410
Mailing Address - Country:US
Mailing Address - Phone:860-388-7838
Mailing Address - Fax:
Practice Address - Street 1:9 BRYON AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4410
Practice Address - Country:US
Practice Address - Phone:860-388-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001199106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist