Provider Demographics
NPI:1740601194
Name:CAROTTA, ALAN JAMES JR (MA, LLP)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JAMES
Last Name:CAROTTA
Suffix:JR
Gender:M
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34935 SCHOOLCRAFT RD STE 106
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1317
Mailing Address - Country:US
Mailing Address - Phone:313-725-1521
Mailing Address - Fax:
Practice Address - Street 1:34935 SCHOOLCRAFT RD STE 106
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1317
Practice Address - Country:US
Practice Address - Phone:734-725-1521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015667103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist