Doctor Name: | TISHINA CARROLL |
NPI Number: | 1154703833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSWA, MSW |
License Number: | P009637 |
Business Practice Address: | 59 Echota Church Rd Cherokee, NC - 287199702 |
Business Phone Number: | 8284979163 |
Business Fax Number: | 8284971723 |
Mailing Address: | 1 Hospital Road Caller Box C-268, CHEROKEE |
State: | NC |
Postal Code: | 287199253 |
Phone Number: | 8284979163 |
Fax Number: | 8284971723 |
NPI Enumeration Date: | 06/18/2015 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | P009637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |