Provider Demographics
NPI:1356721765
Name:CAROLINA COUNSELING AND LIFE COACHING PLLC
Entity type:Organization
Organization Name:CAROLINA COUNSELING AND LIFE COACHING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-967-2632
Mailing Address - Street 1:1403 FOXBORO CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7656
Mailing Address - Country:US
Mailing Address - Phone:919-967-2632
Mailing Address - Fax:919-929-7091
Practice Address - Street 1:112 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4883
Practice Address - Country:US
Practice Address - Phone:919-967-2632
Practice Address - Fax:919-929-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0002531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty