MEDICARE: CAROLINA PATH TO PROGRESS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	2084P0800X	Psychiatry Physician
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1316806896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA PATH TO PROGRESS

Provider Business Mailing Address
First Line	:	5104 REAGAN DR STE 2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1392
Country	:	US
Telephone Number	:	602-731-1172
Fax Number	:

Provider Business Practice Location Address
First Line	:	5104 REAGAN DR STE 2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-1392
Country	:	US
Telephone Number	:	602-731-1172
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MAIAH DAHL
Credential	:
Telephone Number	:	602-731-1172

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “CAROLINA PATH TO PROGRESS ” Practice Location

Language	Start Address	Practice Location

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