Provider Demographics
NPI:1356637367
Name:WOOD, CAROLYN MCCARTER
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MCCARTER
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:MCCARTER
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, MDIV,LCAS
Mailing Address - Street 1:33 HEATHERLY DR
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9557
Mailing Address - Country:US
Mailing Address - Phone:828-778-9902
Mailing Address - Fax:815-361-7428
Practice Address - Street 1:33 HEATHERLY DR
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9557
Practice Address - Country:US
Practice Address - Phone:828-778-9902
Practice Address - Fax:815-361-7428
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1650106H00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)