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NPI Code Detail

MEDICARE: CAROLINA OUTREACH, LLC

MEDICARE: CAROLINA OUTREACH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker8300219NC
22084P0804XChild & Adolescent Psychiatry Physician
3251S00000XCommunity/Behavioral Health Agency8300219NC
41041C0700XClinical Social Worker6005418NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083723266
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA OUTREACH, LLC
Provider Business Mailing Address
First Line : 2670 DURHAM CHAPEL HILL BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27707-2829
Country : US
Telephone Number : 919-251-9001
Fax Number : 919-251-9008
Provider Business Practice Location Address
First Line : 2670 DURHAM CHAPEL HILL BLVD
Second Line :
City : DURHAM
State : NC
Zip : 27707-2829
Country : US
Telephone Number : 919-251-9001
Fax Number : 919-251-9008
Authorized Official
Title or Position : CO-DIRECTOR
Name : MR. TIMOTHY H BROOKS
Credential : LCSW
Telephone Number : 919-251-9001
Provider Enumeration Date : 08/30/2006
Last Update Date : 11/13/2013

Similar Medicare Providers

1568517126 — ELIZABETH B. HAYWOOD LCSW
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax: 919-251-9008
1982682910 — BRAD PRINZHORN
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax: 919-251-9008
1649370149 — MRS. PATRICIA TAYLOR FRANCIS F.N.P.
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax:
1609946391 — JASON ROHACS LMFT
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax: 919-251-9008
1487703112 — MR. THOMAS REID LCSW
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax: 919-251-9008
1740339316 — MRS. KATIE WRIGHT LCSW
Practice Location Address:
2670 DURHAM CHAPEL HILL BLVD
DURHAM, NC
27707-2829
Practice Phone: 919-251-9001
Practice Fax: 919-251-9008

Directions to “CAROLINA OUTREACH, LLC ” Practice Location

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