MEDICARE: CAREY DEETERS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	11365-C	NV
2	1041C0700X	Clinical Social Worker	0904019133	VA
3	1041C0700X	Clinical Social Worker	CW020912	PA

General Provider Information

NPI Number	:	1982002960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAREY DEETERS LCSW

Provider Business Mailing Address
First Line	:	2366 COVEDALE RD
Second Line	:
City	:	WILLIAMSBURG
State	:	PA
Zip	:	16693-7224
Country	:	US
Telephone Number	:	814-330-5781
Fax Number	:

Provider Business Practice Location Address
First Line	:	9528 LINCOLN HWY STE 1
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-3764
Country	:	US
Telephone Number	:	814-623-5077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	04/06/2026

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Directions to “ CAREY DEETERS LCSW” Practice Location

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