Provider Demographics
NPI:1922434042
Name:CARTHEN, JACQUELINE LYDIA (MAED, LPCS, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:LYDIA
Last Name:CARTHEN
Suffix:
Gender:F
Credentials:MAED, LPCS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 MOUNT TABOR ROAD
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-8995
Mailing Address - Country:US
Mailing Address - Phone:910-733-2155
Mailing Address - Fax:
Practice Address - Street 1:112 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-1508
Practice Address - Country:US
Practice Address - Phone:910-802-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS9538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health