Healthcare Provider Details

I. General information

NPI: 1538079462
Provider Name (Legal Business Name): CARRIE ALLYSON DYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 CRYSTAL BAY DRIVE
DENTON NC
27239
US

IV. Provider business mailing address

773 CRYSTAL BAY DRIVE
DENTON NC
27239
US

V. Phone/Fax

Practice location:
  • Phone: 704-796-7046
  • Fax:
Mailing address:
  • Phone: 704-796-7046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23443
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: