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General NPI Number Information
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NPI Number | 1295167211
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Entity Type | Organization
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Legal Business Name | DEETTA ROBERSON CARTER LCSW-C LLC
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 17 WARREN RD SUITE 25A
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City | PIKESVILLE
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State | MD
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Zip | 21208-5334
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Country | US
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Telephone | 410-701-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 17 WARREN RD SUITE 25A
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City | PIKESVILLE
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State | MD
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Zip | 21208-5334
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Country | US
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Telephone | 410-701-0770
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Fax |
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | DEETTA M ROBERSON CARTER
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Credential | MSW, LCSW-C
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Telephone | 410-701-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 17501
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License Number State | MD
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