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NPI Code Detail

MEDICARE: GRACIE LYNNE MCCARROLL LCMHC

MEDICARE: GRACIE LYNNE MCCARROLL LCMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor14987NC
2101YM0800XMental Health Counselor14987NC

General Provider Information

NPI Number : 1164070173
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIE LYNNE MCCARROLL LCMHC
Provider Business Mailing Address
First Line : 4801 GLENWOOD AVE STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 828-989-7022
Fax Number :
Provider Business Practice Location Address
First Line : 4801 GLENWOOD AVE STE 200
Second Line :
City : RALEIGH
State : NC
Zip : 27612-3857
Country : US
Telephone Number : 828-989-7022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2019
Last Update Date : 11/10/2025

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Directions to “ GRACIE LYNNE MCCARROLL LCMHC” Practice Location

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