Healthcare Provider Details

I. General information

NPI: 1245140185
Provider Name (Legal Business Name): ELIZABETH CARTY AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 MILVIA ST STE 450
BERKELEY CA
94704-1297
US

IV. Provider business mailing address

6324 FAIRMOUNT AVE UNIT 34
EL CERRITO CA
94530-6151
US

V. Phone/Fax

Practice location:
  • Phone: 510-224-4458
  • Fax:
Mailing address:
  • Phone: 510-710-1743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number158617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: