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General NPI Number Information
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NPI Number | 1912845595
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Entity Type | Individual
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Provider Name | CARYLEE MICHELLE ORTIZ VALENTIN LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 100 BILLINGSLEY RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-1002
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Country | US
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Telephone | 704-445-6882
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Fax | 704-376-3384
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Provider Business Mailing Address
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Address Line | 5332 ALLISON LN
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City | CHARLOTTE
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State | NC
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Zip | 28277-2609
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Country | US
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Telephone | 321-960-4750
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 30697
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License Number State | NC
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