Healthcare Provider Details
I. General information
NPI: 1760685945
Provider Name (Legal Business Name): CARENET, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2007
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
131 W LEBANON ST SUITE C&E
MOUNT AIRY NC
27030-2935
US
IV. Provider business mailing address
131 W LEBANON ST SUITE C&E
MOUNT AIRY NC
27030-2935
US
V. Phone/Fax
- Phone: 336-786-1922
- Fax: 336-786-1923
- Phone: 336-786-1922
- Fax: 336-786-1923
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
N.
SCOGGIN
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 336-716-7339