Provider Demographics
NPI:1083898977
Name:CACCHIONE, CARRIE ANN (LPC/ NCC)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ANN
Last Name:CACCHIONE
Suffix:
Gender:F
Credentials:LPC/ NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 IDAHO DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4432
Mailing Address - Country:US
Mailing Address - Phone:814-490-0694
Mailing Address - Fax:
Practice Address - Street 1:3332-A BRIDGES ST.
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557
Practice Address - Country:US
Practice Address - Phone:252-648-8602
Practice Address - Fax:252-648-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103804Medicaid