Provider Demographics
NPI:1114968773
Name:CAROLINA MOUNTAIN PSYCHIATRIAC ASSOCIATES
Entity Type:Organization
Organization Name:CAROLINA MOUNTAIN PSYCHIATRIAC ASSOCIATES
Other - Org Name:MURPHY COUNSELING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMERER
Authorized Official - Suffix:
Authorized Official - Credentials:PHYD
Authorized Official - Phone:828-835-7372
Mailing Address - Street 1:PO BOX 995
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0995
Mailing Address - Country:US
Mailing Address - Phone:828-835-7372
Mailing Address - Fax:828-835-8282
Practice Address - Street 1:281 VALLEY RIVER AVE
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-2920
Practice Address - Country:US
Practice Address - Phone:828-835-7372
Practice Address - Fax:828-835-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL 020 041103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC013E2OtherBCBS OF NORTH CAROLINA
NC6005101Medicaid
NC2308010Medicare PIN