Provider Demographics
NPI:1164070173
Name:MCCARROLL, GRACIE LYNNE (LCMHC)
Entity Type:Individual
Prefix:
First Name:GRACIE
Middle Name:LYNNE
Last Name:MCCARROLL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GLEN LENNOX DR UNIT 300
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-4089
Mailing Address - Country:US
Mailing Address - Phone:828-989-7022
Mailing Address - Fax:
Practice Address - Street 1:101 GLEN LENNOX DR UNIT 300
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4089
Practice Address - Country:US
Practice Address - Phone:828-989-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14987101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health