| Organization Name: | CAROLINA BEACH COUNSELING, LLC |
| NPI Number: | 1033557665 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORALIE GRIGAS (OWNER) |
| Mailing Address: | 1328 Lake Park Blvd N Suite 109 Carolina Beach |
| State: | NC US |
| Postal Code: | 284283935 |
| Phone Number: | 9104584544 |
| Fax Number: | 9104584824 |
| NPI Enumeration Date: | 06/05/2013 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 4595 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |