Provider Demographics
NPI:1639335011
Name:SUTTON, CAROL ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4800 WATER PARK DRIVE
Mailing Address - Street 2:UNIT A
Mailing Address - City:BELCAMP
Mailing Address - State:MD
Mailing Address - Zip Code:21017
Mailing Address - Country:US
Mailing Address - Phone:410-273-6959
Mailing Address - Fax:
Practice Address - Street 1:7402 YORK ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-273-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3119103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist