Provider Demographics
NPI:1154472306
Name:YORK, CARLA MELANIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:MELANIE
Last Name:YORK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MCKAY CIR
Mailing Address - Street 2:
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-1813
Mailing Address - Country:US
Mailing Address - Phone:315-771-2859
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5438
Practice Address - Country:US
Practice Address - Phone:301-295-4000
Practice Address - Fax:315-772-9498
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015732103TC0700X
FLPY6790103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN