Provider Demographics
NPI:1396485892
Name:CAROLINA COUNSELING CO PLLC
Entity type:Organization
Organization Name:CAROLINA COUNSELING CO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:607-222-4083
Mailing Address - Street 1:227 LODGES LN APT 106
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-4069
Mailing Address - Country:US
Mailing Address - Phone:607-222-4083
Mailing Address - Fax:
Practice Address - Street 1:10420 PARK RD SUITE 100-B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210
Practice Address - Country:US
Practice Address - Phone:607-222-4083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty