Individual provider Active NPI

Carina Wise

  • Marriage & Family Therapist
  • Davidson, NC
National Provider Identifier
1346577111
Registry record updated Nov 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
903 Northeast Dr
Suite 201
Davidson, NC 28036-7416
Phone
(704) 896-7776
NPI assigned
Nov 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

903 Northeast Dr
Suite 201
Davidson, NC 28036-7416

Mailing address

903 Northeast Dr
Suite 201
Davidson, NC 28036-7416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Counseling Center Marriage & Family Therapist CurrentSince Sep 25, 2019 Accepting new patients
Southlake Center for Self Discovery Past Accepting new patients
Southlake Counseling & Consulting Past Accepting new patients

Locations

1215 Manor Dr
Ste 209
Mechanicsburg, PA 17055
Phone (320) 279-9304

Organizations & group practices 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258243200000",
    "number": "1346577111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR",
            "address_2": "SUITE 201",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR",
            "address_2": "SUITE 201",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367416",
            "telephone_number": "704-896-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "CARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-15",
        "last_updated": "2009-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.