Provider Demographics
NPI:1093199515
Name:JONES, CAROLINE COURTNEY DYER (LCAS NC #21483)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:COURTNEY DYER
Last Name:JONES
Suffix:
Gender:F
Credentials:LCAS NC #21483
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 ALAMANCE RD STE E
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6176
Mailing Address - Country:US
Mailing Address - Phone:919-548-7125
Mailing Address - Fax:
Practice Address - Street 1:402 ALAMANCE RD STE E
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6176
Practice Address - Country:US
Practice Address - Phone:919-548-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21483101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)