Provider Demographics
NPI:1245600816
Name:CAROLINA THERAPY SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:CAROLINA THERAPY SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOREE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-562-3095
Mailing Address - Street 1:5513 MONROE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-5503
Mailing Address - Country:US
Mailing Address - Phone:704-562-3095
Mailing Address - Fax:704-562-3095
Practice Address - Street 1:5513 MONROE RD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5503
Practice Address - Country:US
Practice Address - Phone:704-608-1269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1386975597OtherINDIVIDUAL NPI
NC1386975597OtherINDIVIDUAL NPI
UT1780873059OtherINDIVIDUAL NPI
NC129516954OtherINDIVIDUAL NPI
NC140703011OtherINDIVIDUAL NPI
NC1881870772OtherINDIVIDUAL NPI