Individual
JORGE CARABALLO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
1931 J N PEASE PL STE 201, CHARLOTTE, NC 28262-4543
(704) 885-0268
Mailing address
2625 DANZANTE PL, FAYETTEVILLE, NC 28306-9365
(910) 229-7248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14060
NC
101YP2500X
Professional Counselor
A14060
NC
Other
Enumeration date
07/18/2018
Last updated
02/09/2021
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