Bonnie Frank Carter, PH.D. – Clinical Psychologist

Key facts

NPI: 1497932495
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: PS003878L (PA)
Practice address: 939 Radnor Rd
Wayne, PA 19087-2701
Phone: (610) 688-9060
Fax: (610) 688-9061
NPI assigned: Jan 22, 2008
Sex: Female
Sole proprietor: Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Philosophy

State licenses

License	State	Type	Specialty
PS003878L	PA	MD	Psychologist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Psychologist	103T00000X	PS003878L	PA
Clinical Psychologist	103TC0700X	PS003878L	PA	Yes

Addresses

Primary practice location

939 Radnor Rd
Wayne, PA 19087-2701

Mailing address

939 Radnor Rd
Wayne, PA 19087-2701
Phone (610) 688-9060

Other identifiers

Identifier	Type	State	Issuer
0019604320001	Medicaid	PA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 2, 2011.

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1497932495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 RADNOR RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872701",
            "telephone_number": "610-688-9060",
            "fax_number": "610-688-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "939 RADNOR RD",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872701",
            "telephone_number": "610-688-9060",
            "fax_number": "610-688-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "BONNIE FRANK",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS003878L",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS003878L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019604320001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

All providers in Wayne, PA · Clinical Psychologist in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.