Healthcare Provider Details

I. General information

NPI: 1154236610
Provider Name (Legal Business Name): CARLYN GARRETT LCMHC-A LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

IV. Provider business mailing address

100 BILLINGSLEY RD
CHARLOTTE NC
28211-1002
US

V. Phone/Fax

Practice location:
  • Phone: 980-580-4374
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-31568
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23288
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: