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General NPI Number Information
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NPI Number | 1083254270
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Entity Type | Individual
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Provider Name | BRANDY RAE CARLTON LCMHC, LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 10/16/2022
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Provider Practice Location Address
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Address Line | 135 MACARTHUR ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5410
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Country | US
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Telephone | 366-689-9723
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Fax | 855-941-6011
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Provider Business Mailing Address
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Address Line | 135 MACARTHUR ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5410
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Country | US
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Telephone | 366-689-9723
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Fax | 855-941-6011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 15498
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-26186
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15498
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License Number State | NC
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