Provider Demographics
NPI:1528408002
Name:ABELLO, CAROLINA MARIA (LCAS, CCS)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINA
Middle Name:MARIA
Last Name:ABELLO
Suffix:
Gender:F
Credentials:LCAS, CCS
Other - Prefix:MRS
Other - First Name:CAROLINA
Other - Middle Name:MARIA
Other - Last Name:ABELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCAS, CCS
Mailing Address - Street 1:510 S ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-2735
Mailing Address - Country:US
Mailing Address - Phone:980-201-1979
Mailing Address - Fax:704-735-7370
Practice Address - Street 1:150 BUENA VALE DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-8509
Practice Address - Country:US
Practice Address - Phone:704-864-9668
Practice Address - Fax:704-864-1788
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC611101YA0400X
NCCCS #319101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)