Mr Larry Wayne Clubine, BA, CSAC | |
1329 Robeson St, Fayetteville, NC 28305-5531 | |
(910) 438-0939 | |
Not Available |
Full Name | Mr Larry Wayne Clubine |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 1329 Robeson St, Fayetteville, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033386610 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YA0400X | Counselor - Addiction (substance Use Disorder) | INTERN (North Carolina) | Primary |
Entity Name | Carolina Outreach, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083723266 PECOS PAC ID: 0446449748 Enrollment ID: O20110118000335 |
Mailing Address | Practice Location Address |
---|---|
Mr Larry Wayne Clubine, BA, CSAC 911 Hay St, Fayetteville, NC 28305-5313 Ph: (910) 438-0939 | Mr Larry Wayne Clubine, BA, CSAC 1329 Robeson St, Fayetteville, NC 28305-5531 Ph: (910) 438-0939 |
Annie Rasheedah Hasan, LCAS-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 1340 Mcarthur Rd, Fayetteville, NC 28311 Phone: 910-624-6513 Fax: 910-568-5385 | |
Rivette Cole, LCASA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2820 Bolla Dr, Fayetteville, NC 28306 Phone: 910-797-6511 Fax: 910-491-1000 | |
Ms. Katherine Patricia Hand, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 315 Dick St, Fayetteville, NC 28301 Phone: 910-868-6092 | |
Patricia Sunshine Duggan, LCMCHA, LCASA,NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5135 Morganton Rd Ste 104, Fayetteville, NC 28314 Phone: 910-216-9256 | |
Mazie Ellis, LCSWA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3605 Camson Rd, Fayetteville, NC 28306 Phone: 910-391-4520 | |
Nicole Turner, CADC-R Counselor Medicare: Not Enrolled in Medicare Practice Location: 3427 Melrose Rd, Fayetteville, NC 28304 Phone: 910-900-8256 | |
Shirley Ann White-snead, Counselor Medicare: Not Enrolled in Medicare Practice Location: 324 Person St, Fayetteville, NC 28301 Phone: 910-438-0939 Fax: 910-438-0942 |