Individual
MRS. CARLITA J RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
301 MCCULLOUGH DR, CHARLOTTE, NC 28262-3310
(412) 977-1273
Mailing address
1214 BOTTLE BRUSH LN, HARRISBURG, NC 28075-6715
(412) 977-1273
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NC
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
01/02/2007
Last updated
01/12/2023
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