Carters Comprehensive Support Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CARTERS COMPREHENSIVE SUPPORT SERVICES LLC

Practice address

2311 Pinefield Rd
Waldorf, MD 20601-3235

Phone

(240) 412-7039

NPI assigned

Oct 19, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dawn Nicole Gillom-Carter, MHS,MS, HS-BCP

Title

Owner/ Ceo

Phone

(240) 412-7039

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1255842001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 PINEFIELD RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013235",
            "telephone_number": "240-412-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 PINEFIELD RD",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013235",
            "telephone_number": "240-412-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARTERS COMPREHENSIVE SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "GILLOM-CARTER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "240-412-7039",
        "authorized_official_credential": "MHS,MS, HS-BCP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dwaine Carr
• Carter-Lambert Divisions
• Denitra Raeniece Carter
• Kevin Mark Carter, L.P.C
• Kiara Renee Carter, DPT
• Yvette Camille Cartwright-Wynn
• Imelda Oriel Castelo
• Arnel C Castrence, M.D.
• Carrie Catalan, CRNP
• Sharon L Cave, CRNP

• Community/Behavioral Health Agency in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.