Provider Demographics
NPI:1497707194
Name:WHITEHEAD, CARRIE L (AUD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:L
Other - Last Name:ADAMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:1000 ELMWOOD AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3092
Mailing Address - Country:US
Mailing Address - Phone:585-360-2540
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 400
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3092
Practice Address - Country:US
Practice Address - Phone:585-360-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001935-1174400000X
NY14000018507174400000X
NY001935231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7102000NY14626OtherBC/BS OF MICHIGAN
NY142140AIOtherPREFERRED CARE
NYP010001935OtherEXCELLUS
NY0007528631OtherAETNA
NY050564171OtherSCREEN ACTORS GUILD
NY050564171OtherUNITED HEALTH CARE
NYP00249342OtherRAILROAD MEDICARE PIN
NY0007528631OtherAETNA
NY050564171OtherAHAC TIN
NY7102000NY14626OtherBC/BS OF MICHIGAN