Provider Demographics
NPI:1871743419
Name:CARTER, KATRINA L (LICSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 COOL SPRING RD
Mailing Address - Street 2:
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2254
Mailing Address - Country:US
Mailing Address - Phone:202-419-9020
Mailing Address - Fax:
Practice Address - Street 1:2409 COOL SPRING RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-2254
Practice Address - Country:US
Practice Address - Phone:202-419-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC30008261041C0700X
MD132251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical