Provider Demographics
NPI:1154476166
Name:SHEKHAR, CAROL GRAHAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:GRAHAM
Last Name:SHEKHAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:M
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1521 CONCORD PIKE STE 301
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3644
Mailing Address - Country:US
Mailing Address - Phone:302-543-5755
Mailing Address - Fax:302-295-0331
Practice Address - Street 1:1521 CONCORD PIKE STE 301
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3644
Practice Address - Country:US
Practice Address - Phone:302-543-5755
Practice Address - Fax:855-414-3935
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000719103T00000X, 103TC0700X
PAPS015843103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
145700Medicare PIN