Provider Demographics
NPI:1205644853
Name:CARROLL-STRICKLAND, MICAELA
Entity type:Individual
Prefix:
First Name:MICAELA
Middle Name:
Last Name:CARROLL-STRICKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 GREENCASTLE CT APT B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-2629
Mailing Address - Country:US
Mailing Address - Phone:919-389-9131
Mailing Address - Fax:
Practice Address - Street 1:110 CAPCOM AVE STE 101
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6531
Practice Address - Country:US
Practice Address - Phone:910-232-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician