Provider Demographics
NPI:1154112274
Name:CAROLINA HEALTH ASSOCIATES PC
Entity type:Organization
Organization Name:CAROLINA HEALTH ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-C
Authorized Official - Phone:910-224-5636
Mailing Address - Street 1:1817 GENTLE BEND WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-6283
Mailing Address - Country:US
Mailing Address - Phone:910-224-5636
Mailing Address - Fax:910-224-5636
Practice Address - Street 1:1817 GENTLE BEND WAY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6283
Practice Address - Country:US
Practice Address - Phone:910-224-5636
Practice Address - Fax:910-224-5636
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NC TELEHEALTH PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty