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Organization

CAROLINA OUTREACH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TOM REID MSW, LCSW (CO-DIRECTOR)
(919) 251-9001
Entity
Organization

Contact information

Practice address
1823 CHAPEL HILL RD, DURHAM, NC 27707-1100
(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
101YM0800X
Mental Health Counselor
NC
1041C0700X
Clinical Social Worker
251S00000X
Community/Behavioral Health Agency
Primary
3410049
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300219
NC
Enumeration date
08/18/2010
Last updated
07/14/2021
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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