Healthcare Provider Details

I. General information

NPI: 1578467395
Provider Name (Legal Business Name): KARI WOODARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 FERNCREEK DR
FAYETTEVILLE NC
28314-2563
US

IV. Provider business mailing address

4140 FERNCREEK DR
FAYETTEVILLE NC
28314-2563
US

V. Phone/Fax

Practice location:
  • Phone: 910-779-0100
  • Fax:
Mailing address:
  • Phone: 910-779-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23594
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: