Provider Demographics
NPI:1477923530
Name:WESTERN, CAROLYN (BA, CSAC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WESTERN
Suffix:
Gender:F
Credentials:BA, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 AUTUMN SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-7228
Mailing Address - Country:US
Mailing Address - Phone:919-673-2146
Mailing Address - Fax:919-639-6322
Practice Address - Street 1:431 JUNNY RD
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-5653
Practice Address - Country:US
Practice Address - Phone:919-673-2146
Practice Address - Fax:919-639-6322
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)