Healthcare Provider Details

I. General information

NPI: 1518826411
Provider Name (Legal Business Name): CAROLINA COGNITIVE AND BEHAVIORAL HEALTH CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S MAIN ST STE 212
HOLLY SPRINGS NC
27540-4201
US

IV. Provider business mailing address

300 S MAIN ST STE 212
HOLLY SPRINGS NC
27540-4201
US

V. Phone/Fax

Practice location:
  • Phone: 984-400-2048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAIME HAVAH ELIANA MICHAELS
Title or Position: OWNER/MANAGING MEMBER
Credential: DNP, MSN, PMHNP-BC
Phone: 984-399-9688