| Carolina's Therapy Solutions | |
|
1009 Wickerby Ct Indian Trail NC 28079-3738 | |
| (704) 608-0445 | |
| Not Available |
| Full Name | Carolina's Therapy Solutions |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1009 Wickerby Ct, Indian Trail, North Carolina |
| Authorized Official Name and Position | Jon Wayne Eccleston (OWNER) |
| Authorized Official Contact | 7046080445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina's Therapy Solutions Po Box 634 Indian Trail NC 28079-0634 Ph: (704) 608-0445 | Carolina's Therapy Solutions 1009 Wickerby Ct Indian Trail NC 28079-3738 Ph: (704) 608-0445 |
| NPI Number | 1740463439 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 12/17/2007 |
| Medicare PECOS PAC ID | 5597996306 |
|---|---|
| Medicare Enrollment ID | O20140320000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740463439 | NPI | - | NPPES |
| 6003091 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
| Provider Name | Jon W Eccleston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306937750 PECOS PAC ID: 9537179791 Enrollment ID: I20060502000740 |
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