Healthcare Provider Details

I. General information

NPI: 1508617663
Provider Name (Legal Business Name): JANNA BARTON CARLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 GREENVILLE HWY
BREVARD NC
28712-4792
US

IV. Provider business mailing address

329 CHELSEA CIR
PISGAH FOREST NC
28768-9069
US

V. Phone/Fax

Practice location:
  • Phone: 770-547-2370
  • Fax:
Mailing address:
  • Phone: 770-547-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA20463
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: