Provider Demographics
NPI:1457532095
Name:CARTER, CAROLYN E (CCS)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:CARTER
Suffix:
Gender:F
Credentials:CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:WENTWORTH
Mailing Address - State:NC
Mailing Address - Zip Code:27375-0355
Mailing Address - Country:US
Mailing Address - Phone:336-342-8316
Mailing Address - Fax:336-342-8352
Practice Address - Street 1:405 NC 65
Practice Address - Street 2:
Practice Address - City:WENTWORTH
Practice Address - State:NC
Practice Address - Zip Code:27375-0355
Practice Address - Country:US
Practice Address - Phone:336-342-8316
Practice Address - Fax:336-342-8352
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC079101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)