Organization
CAROLINAS MEDICAL CENTER
Active
Parent organization
CAROLINAS MEDICAL CENTER
Other names
Teen Health Connection
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINAS MEDICAL CENTER
Authorized official
SCOTT RISSMILLER (ENTERPRISE EVP)
(704) 355-8675
Entity
Organization
Contact information
Practice address
3541 RANDOLPH RD, STE 206, CHARLOTTE, NC 28211-1082
(704) 381-8336
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
(704) 631-0002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Enumeration date
12/18/2009
Last updated
03/09/2023
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