Provider Demographics
NPI:1295076974
Name:ALLEN, CAROLYN
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 TOMLINSON ST
Mailing Address - Street 2:E-3
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-3744
Mailing Address - Country:US
Mailing Address - Phone:910-843-6899
Mailing Address - Fax:
Practice Address - Street 1:825 TOMLINSON ST
Practice Address - Street 2:E-3
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3744
Practice Address - Country:US
Practice Address - Phone:910-843-6899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver
No174H00000XOther Service ProvidersHealth Educator