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General NPI Number Information
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NPI Number | 1982490140
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Entity Type | Individual
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Provider Name | KATHERINE CARBOCCI LCMCHA
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Gender | Female
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 3901 BARRETT DR STE 100
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City | RALEIGH
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State | NC
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Zip | 27609-6523
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Country | US
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Telephone | 919-900-7552
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Fax |
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Provider Business Mailing Address
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Address Line | 815 BACK BAY RD
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City | MANTEO
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State | NC
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Zip | 27954-8015
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Country | US
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Telephone | 252-619-1154
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A19298
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License Number State | NC
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