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NPI Code Detail

MEDICARE: CAROLINA THERAPEUTIC SERVICES, INC

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 License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor
4104100000XSocial Worker
51041C0700XClinical Social Worker
62084P0800XPsychiatry Physician
7363L00000XNurse Practitioner
8363LP0808XPsychiatric/Mental Health Nurse Practitioner
9251S00000XCommunity/Behavioral Health Agency
10363A00000XPhysician Assistant
11261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)16009IL

General Provider Information

NPI Number : 1992256218
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 : 2715 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 773-360-1389
Fax Number : 773-687-9412
Authorized Official
Title or Position : CEO
Name : CLARENCE SUTTON
Credential :
Telephone Number : 704-864-1477
Provider Enumeration Date : 10/21/2016
Last Update Date : 10/15/2024

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Directions to “CAROLINA THERAPEUTIC SERVICES, INC ” Practice Location

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