Healthcare Provider Details

I. General information

NPI: 1477810034
Provider Name (Legal Business Name): CARTER CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 NOBLE ST SUITE A
SMITHFIELD NC
27577-9300
US

IV. Provider business mailing address

PO BOX 99778
RALEIGH NC
27624-9778
US

V. Phone/Fax

Practice location:
  • Phone: 919-848-0132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MYLEME HARRISON
Title or Position: CEO
Credential: MD
Phone: 919-848-0132