Provider Demographics
NPI:1215198999
Name:GILLESPIE, CARTER B (CEAP, LPC)
Entity Type:Individual
Prefix:
First Name:CARTER
Middle Name:B
Last Name:GILLESPIE
Suffix:
Gender:M
Credentials:CEAP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S SEVENTH ST
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-2714
Mailing Address - Country:US
Mailing Address - Phone:336-855-4427
Mailing Address - Fax:336-855-4289
Practice Address - Street 1:304 S SEVENTH ST
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-2714
Practice Address - Country:US
Practice Address - Phone:336-855-4427
Practice Address - Fax:336-855-4289
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional