Provider Demographics
NPI:1043474059
Name:CARPENTER, MARK ARNOLD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ARNOLD
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BAY ST STE 307
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2796
Mailing Address - Country:US
Mailing Address - Phone:410-819-5915
Mailing Address - Fax:410-819-0591
Practice Address - Street 1:301 BAY ST STE 307
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2796
Practice Address - Country:US
Practice Address - Phone:410-819-5915
Practice Address - Fax:410-819-0591
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02305101YA0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical