Provider Demographics
NPI:1285947986
Name:RAWLINSON, CAROL M (DMIN, LMFT)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:RAWLINSON
Suffix:
Gender:F
Credentials:DMIN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 MIMOSA BLVD
Mailing Address - Street 2:BLDG C
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4410
Mailing Address - Country:US
Mailing Address - Phone:770-261-1785
Mailing Address - Fax:770-650-2996
Practice Address - Street 1:814 MIMOSA BLVD
Practice Address - Street 2:BLDG C
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4410
Practice Address - Country:US
Practice Address - Phone:770-261-1785
Practice Address - Fax:770-650-2996
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist