Provider Demographics
NPI:1811427024
Name:JAMES, CARLTON THOMAS (PH D, PSY D)
Entity type:Individual
Prefix:
First Name:CARLTON
Middle Name:THOMAS
Last Name:JAMES
Suffix:
Gender:M
Credentials:PH D, PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3186 STATE ROUTE 27 STE 106
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1513
Mailing Address - Country:US
Mailing Address - Phone:609-306-1533
Mailing Address - Fax:
Practice Address - Street 1:3186 STATE ROUTE 27
Practice Address - Street 2:SUITE 106
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1513
Practice Address - Country:US
Practice Address - Phone:609-306-1533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ001751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical