Healthcare Provider Details

I. General information

NPI: 1235055666
Provider Name (Legal Business Name): MOBILE COUNSELING OF THE CAROLINAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 LATROBE DR STE 850X
CHARLOTTE NC
28211-4827
US

IV. Provider business mailing address

3719 LATROBE DR STE 850X
CHARLOTTE NC
28211-4827
US

V. Phone/Fax

Practice location:
  • Phone: 704-517-5455
  • Fax:
Mailing address:
  • Phone: 704-517-5455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. REGGIE YOUNG III
Title or Position: CEO
Credential:
Phone: 704-517-5455