Provider Demographics
NPI:1134316342
Name:ATHERTON, CAROLIE TOMPKINS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CAROLIE
Middle Name:TOMPKINS
Last Name:ATHERTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0415
Mailing Address - Country:US
Mailing Address - Phone:910-426-7337
Mailing Address - Fax:910-424-1418
Practice Address - Street 1:3436 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1834
Practice Address - Country:US
Practice Address - Phone:910-426-7337
Practice Address - Fax:910-424-1418
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0026491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty