Organization
CAROLINAS COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA CUPP (PRESIDENT)
(704) 455-6433
Entity
Organization
Contact information
Practice address
1445 E 7TH ST, SUITE 206, CHARLOTTE, NC 28204-2407
(704) 351-6562
Mailing address
7895 FOXCROFT LN, CHARLOTTE, NC 28213-3878
(704) 455-6433
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3106
NC
Other
Enumeration date
12/27/2007
Last updated
02/09/2009
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