Provider Demographics
NPI:1487960308
Name:GETTY, CARMEN L (LCPC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:L
Last Name:GETTY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 RITCHIE HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2410
Mailing Address - Country:US
Mailing Address - Phone:410-757-2077
Mailing Address - Fax:410-757-5184
Practice Address - Street 1:2431 SOLOMONS ISLAND RD STE 200
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3730
Practice Address - Country:US
Practice Address - Phone:410-757-2077
Practice Address - Fax:410-721-2357
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004833101YP2500X
MDLC6154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI004945026Medicaid