Active NPI
Carla Bolton, LCMHC, NCC, CCTP
- Mental Health Counselor
- Fayetteville, NC
National Provider Identifier
1407335797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 16811
- Practice address
- 2813 Eastover North Dr Fayetteville NC 28312-6705
Fayetteville, NC 28312 - Phone
- (470) 571-6706
- NPI assigned
- Aug 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 16811 | NC | Primary |
Addresses
Primary practice location
2813 Eastover North Dr Fayetteville NC 28312-6705
Fayetteville, NC 28312
Mailing address
2813 Eastover North Dr
Fayetteville, NC 28312-3981
Phone (470) 571-6706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
101 Cabarrus Ave E
Suite 200
Concord, NC 28025-3781
Phone (855) 743-2247
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16811 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eventus Wholehealth, PLLC | Mental Health | Current | Accepting new patients |
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1407335797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2813 EASTOVER NORTH DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283123981",
"telephone_number": "470-571-6706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2813 EASTOVER NORTH DR FAYETTEVILLE NC 28312-6705",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28312",
"telephone_number": "470-571-6706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "CARLA",
"credential": "LCMHC, NCC, CCTP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-08",
"last_updated": "2024-10-25",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "16811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.