Provider Demographics
NPI:1134499510
Name:CARPENTER, ALICIA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:SHARPLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:736 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1346
Mailing Address - Country:US
Mailing Address - Phone:856-649-6241
Mailing Address - Fax:
Practice Address - Street 1:736 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1346
Practice Address - Country:US
Practice Address - Phone:856-649-6241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00663100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health