Healthcare Provider Details

I. General information

NPI: 1821908021
Provider Name (Legal Business Name): KIERA CARLTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3621 BULLARD ST
CHARLOTTE NC
28208-3729
US

IV. Provider business mailing address

3621 BULLARD ST
CHARLOTTE NC
28208-3729
US

V. Phone/Fax

Practice location:
  • Phone: 704-840-8215
  • Fax:
Mailing address:
  • Phone: 704-840-8215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: