Provider Demographics
NPI:1699402065
Name:LANIER, CAROLYN LOVETTE (CRC, LCAS ASSOCIATE)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:LOVETTE
Last Name:LANIER
Suffix:
Gender:F
Credentials:CRC, LCAS ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8819 UNIVERSITY EAST DR STE 215B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4131
Mailing Address - Country:US
Mailing Address - Phone:980-999-3405
Mailing Address - Fax:980-999-3550
Practice Address - Street 1:8819 UNIVERSITY EAST DR STE 215B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4131
Practice Address - Country:US
Practice Address - Phone:980-999-3405
Practice Address - Fax:980-999-3550
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCMHC-A101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
NC584887225C00000X
NCLCAS-28108103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor