Provider Demographics
NPI:1528081387
Name:CARRIER, SUSAN L (LCAS CSAC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:CARRIER
Suffix:
Gender:F
Credentials:LCAS CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 CALLAHAN-KOON ROAD
Mailing Address - Street 2:
Mailing Address - City:SPINDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28160-2207
Mailing Address - Country:US
Mailing Address - Phone:828-288-8773
Mailing Address - Fax:828-288-9577
Practice Address - Street 1:271 CALLAHAN KOON ROAD
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-2207
Practice Address - Country:US
Practice Address - Phone:828-288-8773
Practice Address - Fax:828-288-9577
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2120101YA0400X
NC1112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6111967Medicaid