Provider Demographics
NPI:1245466432
Name:CARSCADDON, DAVID MITCHELL (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MITCHELL
Last Name:CARSCADDON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 NORWOOD ST
Mailing Address - Street 2:P.O.BOX 7315
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-4321
Mailing Address - Country:US
Mailing Address - Phone:704-406-4437
Mailing Address - Fax:
Practice Address - Street 1:618 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4321
Practice Address - Country:US
Practice Address - Phone:704-406-4437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health