Provider Demographics
NPI:1487758884
Name:NEIL C CARTER PHD PC
Entity type:Organization
Organization Name:NEIL C CARTER PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-837-6723
Mailing Address - Street 1:PO BOX 2480
Mailing Address - Street 2:
Mailing Address - City:OCEAN BLUFF
Mailing Address - State:MA
Mailing Address - Zip Code:02065-2480
Mailing Address - Country:US
Mailing Address - Phone:781-837-6723
Mailing Address - Fax:
Practice Address - Street 1:419 OCEAN ST
Practice Address - Street 2:
Practice Address - City:OCEAN BLUFF
Practice Address - State:MA
Practice Address - Zip Code:02065-2480
Practice Address - Country:US
Practice Address - Phone:781-837-6723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIL C CARTER PHD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-08
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4304103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty