Provider Demographics
NPI:1477942837
Name:WORKMAN, CAROLINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 FARRINGDOM ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359
Mailing Address - Country:US
Mailing Address - Phone:910-671-9629
Mailing Address - Fax:910-671-9630
Practice Address - Street 1:4902 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470
Practice Address - Country:US
Practice Address - Phone:910-754-3484
Practice Address - Fax:910-754-3485
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467485367Medicaid