Provider Demographics
NPI:1104225424
Name:FIELDS, CARRIE (LCSW-A)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 CAMWAY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-3416
Mailing Address - Country:US
Mailing Address - Phone:336-587-6856
Mailing Address - Fax:
Practice Address - Street 1:311 N 2ND ST STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3955
Practice Address - Country:US
Practice Address - Phone:336-587-6856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-22
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP009120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker