Provider Demographics
NPI:1801025010
Name:CAROLINA COUNSELING AND CONSULTATION, LLC
Entity Type:Organization
Organization Name:CAROLINA COUNSELING AND CONSULTATION, LLC
Other - Org Name:CAROLINA COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALLINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, LCAS, CCS
Authorized Official - Phone:704-213-2770
Mailing Address - Street 1:417 N MAIN ST STE C
Mailing Address - Street 2:CORPORATE SQUARE
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-4376
Mailing Address - Country:US
Mailing Address - Phone:704-636-5522
Mailing Address - Fax:704-636-5533
Practice Address - Street 1:417 N MAIN ST STE C
Practice Address - Street 2:CORPORATE SQUARE
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4376
Practice Address - Country:US
Practice Address - Phone:704-636-5522
Practice Address - Fax:704-636-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty