Provider Demographics
NPI:1407913742
Name:CARTERET COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:CARTERET COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MRDJENOVIC
Authorized Official - Suffix:III
Authorized Official - Credentials:CCS, CSAC
Authorized Official - Phone:252-247-1109
Mailing Address - Street 1:105 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3806
Mailing Address - Country:US
Mailing Address - Phone:252-247-1109
Mailing Address - Fax:252-247-1107
Practice Address - Street 1:3820 BRIDGES ST
Practice Address - Street 2:STE B
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2979
Practice Address - Country:US
Practice Address - Phone:252-247-1109
Practice Address - Fax:252-247-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-016-034101Y00000X, 101YA0400X, 101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301794Medicaid
NC6006028Medicaid
NCMHL 016-034OtherMH/DD/SAS