MEDICARE: CICELY RASHEEDAH CARTER

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1992648216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CICELY RASHEEDAH CARTER

Provider Business Mailing Address
First Line	:	20201 SHEFFIELD PL
Second Line	:
City	:	SOUTH CHESTERFIELD
State	:	VA
Zip	:	23803-1635
Country	:	US
Telephone Number	:	804-943-1713
Fax Number	:	757-568-1275

Provider Business Practice Location Address
First Line	:	223 E CITY HALL AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1724
Country	:	US
Telephone Number	:	804-255-8536
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2026
Last Update Date	:	04/11/2026

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