MEDICARE: CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1306653365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC

Provider Business Mailing Address
First Line	:	1528 UNION RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2200
Country	:	US
Telephone Number	:	704-864-1477
Fax Number	:

Provider Business Practice Location Address
First Line	:	3015 W HARRISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3342
Country	:	US
Telephone Number	:	704-615-8669
Fax Number	:

Authorized Official
Title or Position	:	EXEC DIRECTOR
Name	:	ALVINA STREET
Credential	:
Telephone Number	:	704-615-8669

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

Similar Medicare Providers

1669002309 — MS. NATALIE N SAGER LCSW
Practice Location Address:

3019 W HARRISON ST
CHICAGO, IL
60612-3342

Practice Phone: 773-638-5703
Practice Fax:

1881217461 — DEMI MOSES
Practice Location Address:

3049 W HARRISON ST
CHICAGO, IL
60612-3342

Practice Phone: 773-533-9605
Practice Fax:

1962140848 — CHUKWUDEBELU FRANKLIN EJIOGU
Practice Location Address:

3019 W HARRISON ST
CHICAGO, IL
60612-3342

Practice Phone: 423-788-4232
Practice Fax:

1154051654 — ELANA RAE COPELAND MA, CADC
Practice Location Address:

3015 W HARRISON ST
CHICAGO, IL
60612-3342

Practice Phone: 773-537-3993
Practice Fax:

1881456754 — LAUREN NICOLE LINTHICUM MS, LPC, CRC
Practice Location Address:

3019 W HARRISON ST
CHICAGO, IL
60612-3342

Practice Phone: 872-463-9639
Practice Fax:

1003609322 — CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC
Practice Location Address:

3015 W HARRISON ST UNIT 1
CHICAGO, IL
60612-3342

Practice Phone: 704-864-1477
Practice Fax:

Directions to “CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.