MEDICARE: CAROLINA PROFESSIONAL COUNSELING SOLUTIONS PLLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1275114324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA PROFESSIONAL COUNSELING SOLUTIONS PLLC

Provider Business Mailing Address
First Line	:	104 N GREEN ST
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-3422
Country	:	US
Telephone Number	:	877-557-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 FALLS ST APT A
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-4362
Country	:	US
Telephone Number	:	877-557-2010
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ THERAPIST
Name	:	LAURA CARSON
Credential	:	LCSW
Telephone Number	:	828-578-3895

Provider Enumeration Date	:	04/20/2021
Last Update Date	:	04/20/2021

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