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NPI Code Detail

MEDICARE: LYNN HENDRICK CARLSON LCMHCA

MEDICARE:   LYNN HENDRICK CARLSON  LCMHCA
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
1101YM0800XMental Health CounselorA20386NC

General Provider Information

NPI Number : 1710704390
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN HENDRICK CARLSON LCMHCA
Provider Business Mailing Address
First Line : 5701 PRESTON LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-5255
Country : US
Telephone Number : 704-296-8091
Fax Number :
Provider Business Practice Location Address
First Line : 5641 PRESTON LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-5253
Country : US
Telephone Number : 704-296-8091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2024
Last Update Date : 09/24/2024

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Directions to “ LYNN HENDRICK CARLSON LCMHCA” Practice Location

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