Basic Information
| Provider Information | |||||||||
| NPI: | 1780973339 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARLIN | ||||||||
| FirstName: | ALYSSA | ||||||||
| MiddleName: | J. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 284 EXECUTIVE PARK DR. | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280251894 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049391118 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5841 HWY. 421 S. | ||||||||
| Address2: | |||||||||
| City: | BUIES CREEK | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275060457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9108935727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2011 | ||||||||
| LastUpdateDate: | 04/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | A8397 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.