Provider Demographics
NPI:1316461924
Name:CARLTON, JOSEPH RANDOLPH (LMFT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RANDOLPH
Last Name:CARLTON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10130 MALLARD CREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-6001
Mailing Address - Country:US
Mailing Address - Phone:704-277-4481
Mailing Address - Fax:704-944-3101
Practice Address - Street 1:10130 MALLARD CREEK RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-6001
Practice Address - Country:US
Practice Address - Phone:704-277-4481
Practice Address - Fax:704-944-3101
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2246106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist