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General NPI Number Information
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NPI Number | 1639837602
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Entity Type | Individual
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Provider Name | SHEENA L CARTER LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 4813B EISENHOWER AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22304-4832
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Country | US
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Telephone | 571-402-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 6612 LAKE PARK DR APT 202
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City | GREENBELT
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State | MD
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Zip | 20770-7012
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Country | US
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Telephone | 804-305-1695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0904013445
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License Number State | VA
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