Provider Demographics
NPI:1053816546
Name:CREMINS, CAROLINE (BA)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:CREMINS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MAXWELL ST RM 6
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-5592
Mailing Address - Country:US
Mailing Address - Phone:910-758-8778
Mailing Address - Fax:
Practice Address - Street 1:159 MAXWELL ST RM 6
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5592
Practice Address - Country:US
Practice Address - Phone:910-758-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor