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NPI 1093694085

NPI 1093694085 : CAROLINA STATELINE COUNSELING LLC : ROCK HILL, SC

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General NPI Number Information
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    NPI Number           |    1093694085
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    Entity Type          |    Organization 
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    Legal Business Name  |    CAROLINA STATELINE COUNSELING LLC 
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Dates
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    Enumeration Date     |    09/02/2025
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    Last Update Date     |    09/02/2025
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Provider Practice Location Address
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    Address Line         |    422 CHESTNUT ST 
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    City                 |    ROCK HILL
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    State                |    SC
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    Zip                  |    29730-5752
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    Country              |    US
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    Telephone            |    864-884-0657
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    422 CHESTNUT ST 
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    City                 |    ROCK HILL
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    State                |    SC
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    Zip                  |    29730-5752
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    Country              |    US
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    Telephone            |    864-884-0657
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/MANAGING MEMBER
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    Name                 |     EMILY  ROLLINS 
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    Credential           |    LISW-CP, LCSW
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    Telephone            |    864-884-0657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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