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General NPI Number Information
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NPI Number | 1104225424
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Entity Type | Individual
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Provider Name | CARRIE FIELDS LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 311 N 2ND ST STE 2
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City | WILMINGTON
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State | NC
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Zip | 28401-3955
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Country | US
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Telephone | 336-587-6856
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Fax |
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Provider Business Mailing Address
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Address Line | 522 CAMWAY DR
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City | WILMINGTON
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State | NC
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Zip | 28403-3416
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Country | US
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Telephone | 336-587-6856
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | P009120
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License Number State | NC
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