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NPI Code Detail

MEDICARE: VICKI CARTER PSYD, LPC

MEDICARE: VICKI CARTER PSYD, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2697CT
2103T00000XPsychologist
3101YM0800XMental Health CounselorMHC01119RI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649428673
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI CARTER PSYD, LPC
Provider Business Mailing Address
First Line : 610 WAMPANOAG TRL
Second Line :
City : RIVERSIDE
State : RI
Zip : 02915-1504
Country : US
Telephone Number : 401-431-9870
Fax Number : 401-437-8847
Provider Business Practice Location Address
First Line : 6 JOHN H CHAFEE BLVD
Second Line :
City : NEWPORT
State : RI
Zip : 02840-1034
Country : US
Telephone Number : 401-848-2160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2008
Last Update Date : 05/06/2020

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