Provider Demographics
NPI:1548771983
Name:CAROLINA ASSESSMENT AND TREATMENT SERVICES
Entity Type:Organization
Organization Name:CAROLINA ASSESSMENT AND TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MIZELLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCAS LPC CCS CSOT
Authorized Official - Phone:252-814-5441
Mailing Address - Street 1:222-C COTANCHE STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858
Mailing Address - Country:US
Mailing Address - Phone:252-814-5441
Mailing Address - Fax:252-215-0520
Practice Address - Street 1:222-C COTANCHE STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-814-5441
Practice Address - Fax:252-215-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)