Healthcare Provider Details

I. General information

NPI: 1962053736
Provider Name (Legal Business Name): MEGAN CARTER PHD, PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 OLD KEENE MILL RD STE 101
SPRINGFIELD VA
22152-1849
US

IV. Provider business mailing address

8134 OLD KEENE MILL RD STE 101
SPRINGFIELD VA
22152-1849
US

V. Phone/Fax

Practice location:
  • Phone: 703-569-8731
  • Fax: 703-569-7248
Mailing address:
  • Phone: 703-569-8731
  • Fax: 703-569-7248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: