Provider Demographics
NPI:1942226360
Name:CAROLINA INTEGRATIVE PSYCHOTHERAPY INC.
Entity Type:Organization
Organization Name:CAROLINA INTEGRATIVE PSYCHOTHERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MADER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:919-968-0231
Mailing Address - Street 1:110 CIRCADIAN WAY
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1506 E FRANKLIN ST
Practice Address - Street 2:STE 202
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2825
Practice Address - Country:US
Practice Address - Phone:919-968-0231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty