Provider Demographics
NPI:1316828130
Name:TIPTON, CARTER CAMPBELL (LMSW)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:CAMPBELL
Last Name:TIPTON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 FREEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5730
Mailing Address - Country:US
Mailing Address - Phone:301-219-6398
Mailing Address - Fax:
Practice Address - Street 1:1445 RESEARCH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6130
Practice Address - Country:US
Practice Address - Phone:240-552-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD33741104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker