Provider Demographics
NPI:1053062729
Name:WALSTON, KARLIE BRASWELL (LCMHC, LCAS, CSI)
Entity type:Individual
Prefix:MRS
First Name:KARLIE
Middle Name:BRASWELL
Last Name:WALSTON
Suffix:
Gender:F
Credentials:LCMHC, LCAS, CSI
Other - Prefix:
Other - First Name:KARLIE
Other - Middle Name:DREW
Other - Last Name:BRASWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 WALLACE LN
Mailing Address - Street 2:
Mailing Address - City:MACCLESFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27852-9152
Mailing Address - Country:US
Mailing Address - Phone:252-567-9495
Mailing Address - Fax:
Practice Address - Street 1:29 WALLACE LN
Practice Address - Street 2:
Practice Address - City:MACCLESFIELD
Practice Address - State:NC
Practice Address - Zip Code:27852-9152
Practice Address - Country:US
Practice Address - Phone:252-567-9495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-27757101YA0400X
NC17224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)