Provider Demographics
NPI:1366466153
Name:CARPENTER, JAMES CLINTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CLINTON
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 EASTOWNE DR
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2214
Mailing Address - Country:US
Mailing Address - Phone:919-493-1102
Mailing Address - Fax:919-493-1102
Practice Address - Street 1:727 EASTOWNE DR
Practice Address - Street 2:SUITE 300B
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2214
Practice Address - Country:US
Practice Address - Phone:919-493-1102
Practice Address - Fax:919-493-1102
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC03330OtherBLUE CROSS BLUE SHIELD
NC2810243Medicare ID - Type Unspecified