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NPI Code Detail

MEDICARE: THOMAS CARIVEAU PHD

MEDICARE: THOMAS CARIVEAU PHD
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
1103K00000XBehavior Analyst1-15-21039NC
2103T00000XPsychologist5215NC

General Provider Information

NPI Number : 1407367840
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS CARIVEAU PHD
Provider Business Mailing Address
First Line : 720 SAINT JAMES DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2937
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 720 SAINT JAMES DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2937
Country : US
Telephone Number : 910-660-8200
Fax Number : 910-660-8199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2017
Last Update Date : 03/29/2018

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Directions to “ THOMAS CARIVEAU PHD” Practice Location

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