Provider Demographics
NPI:1811900418
Name:CARTER, ANDREA R (PSYD)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:R
Last Name:CARTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 WINDMILL RD
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1681
Mailing Address - Country:US
Mailing Address - Phone:610-678-3730
Mailing Address - Fax:610-678-7853
Practice Address - Street 1:2909 WINDMILL RD
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1681
Practice Address - Country:US
Practice Address - Phone:610-678-3730
Practice Address - Fax:610-678-7853
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006093L103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACA472428Medicare ID - Type Unspecified
PAR07104Medicare UPIN