Provider Demographics
NPI:1205205739
Name:MONDS, CARLA (LCASA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:MONDS
Suffix:
Gender:F
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-4853
Mailing Address - Country:US
Mailing Address - Phone:910-618-9912
Mailing Address - Fax:910-618-6822
Practice Address - Street 1:901 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4853
Practice Address - Country:US
Practice Address - Phone:910-618-9912
Practice Address - Fax:910-618-6822
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCASA 21720101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)