Organization
DEETTA ROBERSON CARTER LCSW-C LLC
Active
Organization
DEETTA ROBERSON CARTER LCSW-C LLC
Active
Other names
LIVE WELL & THRIVE THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
DEETTA M ROBERSON CARTER MSW, LCSW-C (OWNER/ PROVIDER)
(410) 701-0770
Entity
Organization
Contact information
Practice address
17 WARREN RD, SUITE 25A, PIKESVILLE, MD 21208-5334
(410) 701-0770
Mailing address
17 WARREN RD, SUITE 25A, PIKESVILLE, MD 21208-5334
(410) 701-0770
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17501
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220218200
—
MD
01
—
AJ470001
CAREFIRST BCBS
MD
Enumeration date
08/01/2013
Last updated
08/01/2013
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