Provider Demographics
NPI:1023084191
Name:CARTER, ANNE (PHD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SIMPSON RD
Mailing Address - Street 2:XXXXX
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2813
Mailing Address - Country:US
Mailing Address - Phone:215-776-2222
Mailing Address - Fax:865-589-3805
Practice Address - Street 1:1845 WALNUT ST
Practice Address - Street 2:SUITE 2323
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4708
Practice Address - Country:US
Practice Address - Phone:215-776-2222
Practice Address - Fax:856-589-3805
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6497P103T00000X
NJ2636103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA009251Medicare ID - Type Unspecified