Provider Demographics
NPI:1528282670
Name:LAUGHLIN, CARLYN ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:CARLYN
Middle Name:ANN
Last Name:LAUGHLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 S CROATAN HWY
Mailing Address - Street 2:D7 PMB 21
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959
Mailing Address - Country:US
Mailing Address - Phone:252-255-2733
Mailing Address - Fax:252-255-0787
Practice Address - Street 1:2224 S CROATAN HWY
Practice Address - Street 2:D7 PMB 21
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959
Practice Address - Country:US
Practice Address - Phone:252-255-2733
Practice Address - Fax:252-255-0787
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0020061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003496Medicaid
NC2872072Medicare ID - Type Unspecified