Provider Demographics
NPI:1558247072
Name:CARR, JAYLYN NICOLE (LCSWA)
Entity type:Individual
Prefix:
First Name:JAYLYN
Middle Name:NICOLE
Last Name:CARR
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 MCLEAN AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4327
Mailing Address - Country:US
Mailing Address - Phone:704-915-0885
Mailing Address - Fax:
Practice Address - Street 1:510 S ASPEN ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-2735
Practice Address - Country:US
Practice Address - Phone:704-735-7325
Practice Address - Fax:704-735-7370
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP022736104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker