Organization
CAROLINA OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WILLOW BURGESS-JOHNSON LCSW (DIRECTOR, CAROLINA OUTREACH WEST)
(828) 505-1762
Entity
Organization
Contact information
Practice address
18 REGENT PARK BLVD STE A, ASHEVILLE, NC 28806-3727
(828) 505-1762
(828) 505-1763
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006593
—
NC
Enumeration date
10/28/2008
Last updated
06/06/2012
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