MEDICARE: CAROLINA OUTREACH, LLC

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
1	101YM0800X	Mental Health Counselor		NC
2	1041C0700X	Clinical Social Worker
3	251S00000X	Community/Behavioral Health Agency	3410049	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508171216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA OUTREACH, LLC

Provider Business Mailing Address
First Line	:	2670 DURHAM CHAPEL HILL BLVD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-2829
Country	:	US
Telephone Number	:	919-251-9001
Fax Number	:	919-251-9008

Provider Business Practice Location Address
First Line	:	1823 CHAPEL HILL RD
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-1100
Country	:	US
Telephone Number	:	919-251-9001
Fax Number	:	919-251-9008

Authorized Official
Title or Position	:	CO-DIRECTOR
Name	:	MR. TOM REID
Credential	:	MSW, LCSW
Telephone Number	:	919-251-9001

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	07/14/2021

Similar Medicare Providers

1356553077 — DR. JAMES CECIL THOMPSON DDSPA
Practice Location Address:

1823 CHAPEL HILL RD
DURHAM, NC
27707-1100

Practice Phone: 919-489-6256
Practice Fax:

1629315510 — CINDY LESLIE AROCENA ROBERSON PHARMD
Practice Location Address:

3100 TOWER BLVD STE 1100
DURHAM, NC
27707-2599

Practice Phone: 919-385-1710
Practice Fax:

1548938376 — MRS. CORINNE LOPEZ QP,MSW,LCSW-A
Practice Location Address:

1823 CHAPEL HILL RD
DURHAM, NC
27707-1100

Practice Phone: 631-747-3416
Practice Fax:

1245196815 — SIERA C MERRITT RN
Practice Location Address:

3100 TOWER BLVD STE 1100
DURHAM, NC
27707-2599

Practice Phone: 919-660-9355
Practice Fax:

1417803321 — CAROL ABKEN
Practice Location Address:

3100 TOWER BLVD STE 1100
DURHAM, NC
27707-2599

Practice Phone: 919-660-9355
Practice Fax:

1598603441 — DENISE CERNIGLIA
Practice Location Address:

3100 TOWER BLVD STE 1100
DURHAM, NC
27707-2599

Practice Phone: 919-660-9355
Practice Fax:

Directions to “CAROLINA OUTREACH, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.