Active NPI
Elizabeth Carline Carr, PSY.D.
- Clinical Psychologist
- Gaithersburg, MD
National Provider Identifier
1417073487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4272
- Practice address
- 220 Main St FL 2
Gaithersburg, MD 20878-5471 - Phone
- (301) 356-4505
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4272 | MD | Primary |
Addresses
Primary practice location
220 Main St FL 2
Gaithersburg, MD 20878-5471
Mailing address
8662 Delcris Dr
Montgomery Village, MD 20886-4377
Phone (301) 356-4505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4272 | MD | MD | Clinical Psychologist |
| 04272 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417073487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8662 DELCRIS DR",
"city": "MONTGOMERY VILLAGE",
"state": "MD",
"postal_code": "208864377",
"telephone_number": "301-356-4505",
"fax_number": "301-990-7432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MAIN ST FL 2",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208785471",
"telephone_number": "301-356-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "ELIZABETH",
"middle_name": "CARLINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "4272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.