Healthcare Provider Details

I. General information

NPI: 1245391036
Provider Name (Legal Business Name): CAROLINA BEHAVIORAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MEDICAL CIR STE A
ROCKINGHAM NC
28379-5221
US

IV. Provider business mailing address

PO BOX 1630
PINEHURST NC
28370-1630
US

V. Phone/Fax

Practice location:
  • Phone: 910-895-0980
  • Fax: 910-997-7722
Mailing address:
  • Phone: 910-295-6007
  • Fax: 910-215-0179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELISABETH PESCE
Title or Position: SECRETARY
Credential:
Phone: 904-605-4986