Provider Demographics
NPI:1063047793
Name:CAROLINAS CENTER FOR EVALUATION AND TREATMENT
Entity type:Organization
Organization Name:CAROLINAS CENTER FOR EVALUATION AND TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-756-1615
Mailing Address - Street 1:18151 W CATAWBA AVE UNIT 15
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5641
Mailing Address - Country:US
Mailing Address - Phone:704-756-1615
Mailing Address - Fax:
Practice Address - Street 1:18151 W CATAWBA AVE UNIT 15
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5641
Practice Address - Country:US
Practice Address - Phone:704-756-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty