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General NPI Number Information
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NPI Number | 1396485892
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Entity Type | Organization
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Legal Business Name | CAROLINA COUNSELING CO PLLC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 10420 PARK RD SUITE 100-B
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City | CHARLOTTE
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State | NC
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Zip | 28210
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Country | US
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Telephone | 607-222-4083
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Fax |
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Provider Business Mailing Address
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Address Line | 227 LODGES LN APT 106
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City | CLOVER
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State | SC
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Zip | 29710-4069
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Country | US
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Telephone | 607-222-4083
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | EMILY JOE BURKE
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Credential | LMFT
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Telephone | 607-222-4083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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