Provider Demographics
NPI:1184873226
Name:CARR, SUSAN A (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:A
Last Name:CARR
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 1:560 SPRING OAK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-1757
Mailing Address - Country:US
Mailing Address - Phone:484-678-2536
Mailing Address - Fax:610-430-7626
Practice Address - Street 1:560 SPRING OAK DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-1757
Practice Address - Country:US
Practice Address - Phone:484-678-2536
Practice Address - Fax:610-430-7626
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC005570103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling