| Deetta Roberson Carter Lcsw-c Llc | |
|
17 Warren Rd Suite 25a Pikesville MD 21208-5334 | |
| (410) 701-0770 | |
| Not Available |
| Full Name | Deetta Roberson Carter Lcsw-c Llc |
|---|---|
| Speciality | Social Worker |
| Location | 17 Warren Rd, Pikesville, Maryland |
| Authorized Official Name and Position | Deetta M Roberson Carter (OWNER/ PROVIDER) |
| Authorized Official Contact | 4107010770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deetta Roberson Carter Lcsw-c Llc 17 Warren Rd Suite 25a Pikesville MD 21208-5334 Ph: (410) 701-0770 | Deetta Roberson Carter Lcsw-c Llc 17 Warren Rd Suite 25a Pikesville MD 21208-5334 Ph: (410) 701-0770 |
| NPI Number | 1295167211 |
|---|---|
| Provider Enumeration Date | 08/01/2013 |
| Last Update Date | 08/01/2013 |
| Medicare PECOS PAC ID | 6709170657 |
|---|---|
| Medicare Enrollment ID | O20160816000656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295167211 | NPI | - | NPPES |
| 220218200 | Medicaid | MD | |
| AJ470001 | Other | MD | CAREFIRST BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17501 (Maryland) | Primary |
| Provider Name | Deetta M Roberson-carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760783187 PECOS PAC ID: 2961650445 Enrollment ID: I20120907000676 |
| Provider Name | Latavia M Little |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013356856 PECOS PAC ID: 1456604586 Enrollment ID: I20181019000048 |
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