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CAROLINA OUTREACH LLC NPI 1518110139


NPI Information

NPI: 1518110139
Provider Name: CAROLINA OUTREACH, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 34D2151124

Address:
18 REGENT PARK BLVD STE A
ASHEVILLE, NC
ZIP 28806
Phone: (828) 505-1762
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CAROLINA OUTREACH, LLC is a clinical social worker in Asheville, NC. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. CAROLINA OUTREACH, LLC NPI is 1518110139. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

18 REGENT PARK BLVD STE A
ASHEVILLE, NC
ZIP 28806-727
Phone: (828) 505-1762
Fax: (828) 505-1763

The provider's authorized official is Willow Burgess-johnson .
The authorized official title is Director, Carolina Outreach West and has the following contact phone number (828) 505-1762.

The CLIA number assigned to this NPI record is 34D2151124 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/28/2008 and was last updated on 6/6/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
16006593MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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