Provider Demographics
NPI:1134229743
Name:CARTER, CHRISTOPHER MORGAN (LICSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MORGAN
Last Name:CARTER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130452
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02113-0008
Mailing Address - Country:US
Mailing Address - Phone:617-444-9391
Mailing Address - Fax:
Practice Address - Street 1:121 MOUNT VERNON ST
Practice Address - Street 2:C/O E. FRICK
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-1104
Practice Address - Country:US
Practice Address - Phone:617-444-9391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1150411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA70010000P09367OtherBLUE CROSS BLUE SHIELD