Healthcare Provider Details

I. General information

NPI: 1518893023
Provider Name (Legal Business Name): CAROLINE MERRICK LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 W MAIN ST
ALBEMARLE NC
28001-7457
US

IV. Provider business mailing address

2620 W MAIN ST
ALBEMARLE NC
28001-7457
US

V. Phone/Fax

Practice location:
  • Phone: 239-227-2079
  • Fax: 239-999-1340
Mailing address:
  • Phone: 239-227-2079
  • Fax: 239-999-1340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23055
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: