Individual
MR. CARLSON ANDREWS THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
96 ELDERBERRY LN, ROUGEMONT, NC 27572-9275
(919) 240-9192
Mailing address
96 ELDERBERRY LN, ROUGEMONT, NC 27572-9275
(919) 240-9192
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7744
NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS
NC
Enumeration date
02/25/2010
Last updated
05/22/2023
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