Provider Demographics
NPI:1588149660
Name:MCCARTER, ALICE O'HARA (MSW)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:O'HARA
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 CHEROKEE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2240
Mailing Address - Country:US
Mailing Address - Phone:617-721-6952
Mailing Address - Fax:
Practice Address - Street 1:802 CHEROKEE ROAD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2240
Practice Address - Country:US
Practice Address - Phone:617-721-6952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111163-SW-LICSW1041C0700X
NCC0128231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical