Mr Carlson Andrews Theodore, LCMHC is a medicare enrolled "Counselor - Mental Health" provider in Rougemont, North Carolina. His current practice location is
96 Elderberry Ln, Rougemont, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(919) 240-9192.
Mr Carlson Andrews Theodore is licensed to practice in North Carolina (license number 7744) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699097063.
Healthcare Provider's Profile
Full Name | Mr Carlson Andrews Theodore |
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Gender | Male |
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Speciality | Counselor - Mental Health |
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Location | 96 Elderberry Ln, Rougemont, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699097063
- Provider Enumeration Date: 02/25/2010
- Last Update Date: 05/22/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567810617
- Enrollment ID: I20231129003223
Medical Identifiers
Medical identifiers for Mr Carlson Andrews Theodore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699097063 | NPI | - | NPPES |
7744 | Other | NC | NORTH CAROLINA BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 7744 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Carlson Andrews Theodore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Carlson Andrews Theodore, LCMHC 96 Elderberry Ln, Rougemont, NC 27572-9275 Ph: (919) 240-9192 | Mr Carlson Andrews Theodore, LCMHC 96 Elderberry Ln, Rougemont, NC 27572-9275 Ph: (919) 240-9192 |
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