MEDICARE: CAROLINA MOUNTAIN PSYCHIATRIC ASSOC.

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1891997748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA MOUNTAIN PSYCHIATRIC ASSOC.

Provider Business Mailing Address
First Line	:	PO BOX 995
Second Line	:
City	:	MURPHY
State	:	NC
Zip	:	28906-0995
Country	:	US
Telephone Number	:	828-835-7372
Fax Number	:	828-835-8282

Provider Business Practice Location Address
First Line	:	719 FISHER CREEK RD
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-7708
Country	:	US
Telephone Number	:	828-835-7372
Fax Number	:	828-835-8282

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LINDA KEMERER
Credential	:
Telephone Number	:	828-835-7372

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	09/25/2007

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