MEDICARE: CAITLIN SCAGNELLI LCASA

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-28347	NC

General Provider Information

NPI Number	:	1366175861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN SCAGNELLI LCASA

Provider Business Mailing Address
First Line	:	10319 PRAIRIEGROUSE CT
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-8112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 STATESVILLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3702
Country	:	US
Telephone Number	:	980-428-9634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2022
Last Update Date	:	07/03/2022

Similar Medicare Providers

1346104544 — CHARLOTTE DETOX CENTER, LLC
Practice Location Address:

7349 STATESVILLE RD STE B
CHARLOTTE, NC
28269-3702

Practice Phone: 866-623-4948
Practice Fax:

1306667480 — GABRIELLA COMUNALE DECOSTE PA-C
Practice Location Address:

7349 STATESVILLE RD
CHARLOTTE, NC
28269-3702

Practice Phone: 866-242-3814
Practice Fax:

1669989554 — CAROLINA CENTER FOR RECOVERY
Practice Location Address:

7349 STATESVILLE RD
CHARLOTTE, NC
28269-3702

Practice Phone: 704-844-6958
Practice Fax: 704-973-7875

1215545769 — JASON LEONARD SCIANNO LCSW, LCAS
Practice Location Address:

7349 STATESVILLE RD
CHARLOTTE, NC
28269-3702

Practice Phone: 646-734-6924
Practice Fax:

1124789185 — MRS. JOELLEN ESTELLE BRYSON CADC
Practice Location Address:

7349 STATESVILLE RD
CHARLOTTE, NC
28269-3702

Practice Phone: 866-966-1168
Practice Fax:

1215679121 — CHARLOTTE DETOX CENTER, LLC
Practice Location Address:

7349 STATESVILLE RD STE B
CHARLOTTE, NC
28269-3702

Practice Phone: 866-623-4948
Practice Fax:

Directions to “ CAITLIN SCAGNELLI LCASA” 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 © 2007-2025 (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.