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General NPI Number Information
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NPI Number | 1477607786
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Entity Type | Organization
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Legal Business Name | CAROLINA BEHAVIORAL CARE
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 5505 CREEDMOOR RD STE 100
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City | RALEIGH
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State | NC
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Zip | 27612-6333
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Country | US
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Telephone | 919-852-5352
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Fax | 919-852-5323
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Provider Business Mailing Address
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Address Line | PO BOX 1630
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City | PINEHURST
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State | NC
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Zip | 28370-1630
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Country | US
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Telephone | 910-295-6007
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Fax | 910-215-0179
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ROBERT FLEURY
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Credential | MD
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Telephone | 910-295-6007
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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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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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