Provider Demographics
NPI:1609833490
Name:CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN
Entity Type:Organization
Organization Name:CARTERET CLINIC FOR ADOLESCENTS AND CHILDREN
Other - Org Name:CARTERET CHILDREN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTUSCH-WHITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-726-0511
Mailing Address - Street 1:3510 JOHN PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4321
Mailing Address - Country:US
Mailing Address - Phone:252-726-0511
Mailing Address - Fax:252-726-7441
Practice Address - Street 1:3510 JOHN PLATT DR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4321
Practice Address - Country:US
Practice Address - Phone:252-726-0511
Practice Address - Fax:252-726-7441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4461101YP2500X
NC1501103TB0200X
NC16287208000000X
NC200700362208000000X
NC9800605208000000X
NC201519363LF0000X
NC200683363LF0000X
NC300102363LP0200X
NC005003504363LP0200X
NC5006954363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911756Medicaid
NC0260HOtherBC/BS