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NPI Code Detail

MEDICARE: MICHAEL CHARLES CARRERO BCBA

MEDICARE: MICHAEL CHARLES CARRERO BCBA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1316693120
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL CHARLES CARRERO BCBA
Provider Business Mailing Address
First Line : 1921 30TH ST NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-3225
Country : US
Telephone Number : 203-815-0450
Fax Number :
Provider Business Practice Location Address
First Line : 3628 26TH STREET DR NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-7206
Country : US
Telephone Number : 828-459-6003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2022
Last Update Date : 08/15/2025

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