Provider Demographics
NPI:1861373862
Name:CARLISLE, OLIVIA ROSEMARY
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ROSEMARY
Last Name:CARLISLE
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 1:301 N ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-3538
Mailing Address - Country:US
Mailing Address - Phone:704-819-7931
Mailing Address - Fax:
Practice Address - Street 1:229 S BREVARD ST STE 200E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2495
Practice Address - Country:US
Practice Address - Phone:704-268-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health