Provider Demographics
NPI:1386821965
Name:MILLER-CARROLL, DONNA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:MILLER-CARROLL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 MAWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1412
Mailing Address - Country:US
Mailing Address - Phone:910-263-7238
Mailing Address - Fax:910-487-6268
Practice Address - Street 1:5239 MAWOOD ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-1412
Practice Address - Country:US
Practice Address - Phone:910-263-7238
Practice Address - Fax:910-487-6268
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3836101YP2500X
NCC0015581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional