MEDICARE: CAROLINA THERAPEUTIC SERVICES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	104100000X	Social Worker
2	251S00000X	Community/Behavioral Health Agency
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
4	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1932053253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA THERAPEUTIC SERVICES, 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	:	1538 UNION RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-2205
Country	:	US
Telephone Number	:	704-864-1477
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	DANA LYNN HICKEY
Credential	:
Telephone Number	:	828-758-1320

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	03/16/2026

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