Healthcare Provider Details

I. General information

NPI: 1114833480
Provider Name (Legal Business Name): CAROLINA LEARN AND PLAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 WALL RD STE 100
WAKE FOREST NC
27587-6550
US

IV. Provider business mailing address

1340 WALL R., STE 100
WAKE FOREST NC
27587
US

V. Phone/Fax

Practice location:
  • Phone: 919-810-2792
  • Fax: 919-400-4173
Mailing address:
  • Phone: 919-810-2792
  • Fax: 919-400-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LORI ANN LEWIS
Title or Position: OWNER
Credential: B.S., ITFS
Phone: 919-810-2792