Provider Demographics
NPI:1851486450
Name:CARNEY, LIZBETH BINKS (PHD)
Entity Type:Individual
Prefix:MS
First Name:LIZBETH
Middle Name:BINKS
Last Name:CARNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LIZBETH
Other - Middle Name:T
Other - Last Name:BINKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1501 SULGRAVE AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3650
Mailing Address - Country:US
Mailing Address - Phone:410-493-8029
Mailing Address - Fax:928-441-1539
Practice Address - Street 1:711 W 40TH ST
Practice Address - Street 2:SUITE 404
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2120
Practice Address - Country:US
Practice Address - Phone:410-532-3080
Practice Address - Fax:928-441-1539
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD635261800Medicaid
162855Medicare PIN