Individual provider Active NPI

Shardae Chandra Carter

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1285264804
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LGP10167 Issued in MD
Practice address
1900 N Howard St Ste 300
Baltimore, MD 21218-5909
Phone
(443) 438-6742
Fax
(443) 773-5624
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LGP10167 MD Primary

Addresses

Primary practice location

1900 N Howard St Ste 300
Baltimore, MD 21218-5909

Mailing address

1900 N Howard St Ste 300
Baltimore, MD 21218-5909
Phone (443) 438-6742

Other identifiers 1

IdentifierTypeStateIssuer
38-3876389MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LGP10167MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dae to Dae Counseling Services LLC CurrentSince Jun 18, 2023 Accepting new patients

Locations

1014 W 36th St
Ste 677
Baltimore, MD 21211
Phone (443) 671-7852

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1285264804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 N HOWARD ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185909",
            "telephone_number": "443-438-6742",
            "fax_number": "443-773-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N HOWARD ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185909",
            "telephone_number": "443-438-6742",
            "fax_number": "443-773-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SHARDAE",
        "middle_name": "CHANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP10167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38-3876389",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.