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Individual

MR. JOHN EDWIN CARROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCMHCS

Contact information

Practice address
1425 S GLENBURNIE RD STE 5, NEW BERN, NC 28562-2610
(252) 675-3620
(252) 633-1005
Mailing address
233 SHORELINE DR, NEW BERN, NC 28562-9557
(252) 633-1770
(252) 633-1005

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
3874
NC
101YM0800X
Mental Health Counselor
Primary
S3874
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139X5
BC
NC
05
6102827
NC
Enumeration date
05/01/2006
Last updated
06/23/2021
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