Provider Demographics
NPI:1346675881
Name:WORMAN, CAROLYN M (LPA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:WORMAN
Suffix:
Gender:F
Credentials:LPA
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:M
Other - Last Name:PERKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPA
Mailing Address - Street 1:1213 CULBRETH DR STE 126
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3639
Mailing Address - Country:US
Mailing Address - Phone:910-508-0830
Mailing Address - Fax:
Practice Address - Street 1:1213 CULBRETH DR STE 126
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3639
Practice Address - Country:US
Practice Address - Phone:910-791-9625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4416103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist