Caryn Marie Coons, LPC-S – Professional Counselor

Key facts

NPI: 1033150628
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: LPC 3445 (NC)
Practice address: 1041 Old Ocean Hwy
Bolivia, NC 28422-8584
Phone: (910) 754-7908
Fax: (910) 799-3313
NPI assigned: Jun 8, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Carenet, Inc. Mental Health Counselor · Winston Salem, NC · NPI 1043424013

Medicare reassignment Care Compare group NPD NC
Carenet Inc Professional Counselor · Winston Salem, NC · NPI 1376432492

NPD PROFESSIONAL
Carenet Inc Mental Health Counselor · Bolivia, NC · NPI 1902009855

NPD
Carenet, Inc Professional Counselor · Lexington, NC · NPI 1659946804

NPD (past) PROFESSIONAL
Carenet, Inc. Mental Health Counselor · Wilmington, NC · NPI 1023446515

NPD (past)

Medicare Care Compare profile

Specialty: Mental Health Counselor
Education: Other, 2016
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Carenet Inc (40 clinicians)

Practice addresses (Care Compare)

1041 Old Ocean Hwy
Bolivia, NC 28422-8584
Phone (910) 799-1071

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20240715001176	NC	Practitioner - Mental Health Counselor	3870038847	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
LPC 3445	NC	MD	Professional Counselor
LPC 3338	SC	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Carenet Inc		Current since Feb 10, 2024	Accepting new patients
Carenet, Inc.		Current since Aug 17, 2025	Accepting new patients
Carenet Inc	Professional	Current since Feb 10, 2024	Accepting new patients
Carenet, Inc.		Past	Accepting new patients
Carenet, Inc	Professional	Past since May 25, 2021	Accepting new patients

Locations

114 Highland Ave
Fayetteville, NC 28305
Phone (910) 484-0176

3219 Landmark St
Ste 9
Greenville, NC 27834

4853 Masonboro Loop Rd
Wilmington, NC 28409
Phone (910) 799-1071

610 S College Rd
Wilmington, NC 28403
Phone (910) 799-1071

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	LPC 3338	SC
Professional Counselor	101YP2500X	LPC 3445	NC	Yes

Addresses

Primary practice location

1041 Old Ocean Hwy
Bolivia, NC 28422-8584

Mailing address

610 S College Rd
Wilmington, NC 28403-3202
Phone (910) 799-1071

Other identifiers

Identifier	Type	State	Issuer
6102265	Medicaid	NC
043677617	Other	SC	FORMER TAX ID OF OLD CORP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 1, 2011.

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1033150628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033202",
            "telephone_number": "910-799-1071",
            "fax_number": "910-799-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 OLD OCEAN HWY",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284228584",
            "telephone_number": "910-754-7908",
            "fax_number": "910-799-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONS",
        "first_name": "CARYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "LPC 3338",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "LPC 3445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102265",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FORMER TAX ID OF OLD CORP",
            "identifier": "043677617",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivia, NC

All providers in Bolivia, NC · Professional Counselor in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.