Healthcare Provider Details

I. General information

NPI: 1700929635
Provider Name (Legal Business Name): CAROLINA CARE & COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 SIX FORKS RD SUITE 204
RALEIGH NC
27615-3095
US

IV. Provider business mailing address

8520 SIX FORKS RD SUITE 204
RALEIGH NC
27615-3095
US

V. Phone/Fax

Practice location:
  • Phone: 919-676-1497
  • Fax: 919-676-1430
Mailing address:
  • Phone: 919-676-1497
  • Fax: 919-676-1430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1427
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1427
License Number StateNC

VIII. Authorized Official

Name: DR. ROBERT AIELLO
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 919-676-1497