Adam Michael Carlson, MSW, LCSW-A, LCAS-A

Individual provider Active NPI Clinical Social Worker · Winterville, NC

NPI 1366097883 · NPPES record last updated Oct 22, 2021

Key facts

NPI
1366097883
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C014117 (NC)
Practice address
4054 S Memorial Dr Ste K
Winterville, NC 28590-8690
Phone
(252) 561-8112
Fax
(252) 561-7455
NPI assigned
Aug 2, 2019
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LCAS-25691NCMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-25691 NC
Clinical Social Worker 1041C0700X C014117 NC Yes

Addresses

Primary practice location

4054 S Memorial Dr Ste K
Winterville, NC 28590-8690

Mailing address

231 Commerce St
Greenville, NC 27858-5029
Phone (252) 321-8080

Other practice location 1

231 Commerce St
Greenville, NC 27858-5029
Phone (252) 321-8080

Electronic endpoints

TypeEndpointUseAffiliation
Other URL Winterville Direct

Other providers in Winterville, NC

All providers in Winterville, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.