Organization
CAROLINA OUTREACH, LLC
Active
Organization
CAROLINA OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY H BROOKS LCSW (CO-DIRECTOR)
(919) 251-9001
Entity
Organization
Contact information
Practice address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(919) 251-9001
(919) 251-9008
Mailing address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(919) 251-9001
(919) 251-9008
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6005418
NC
1041C0700X
Clinical Social Worker
8300219
NC
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
8300219
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5904169
—
NC
05
—
6005418
—
NC
05
—
8300219
—
NC
Enumeration date
08/30/2006
Last updated
11/13/2013
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