# MEDICAL ASSESSMENT CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548511595
- **Authorized official:** MS. LAN LE BONNO LEBOZEC (PRESIDENT)
- **Authorized official phone:** (980) 229-3722

## Contact information

- **Practice address:** 4912 ALBEMARLE RD, CHARLOTTE, NC 28205-6618
- **Practice address phone:** (980) 229-3722
- **Practice address fax:** (704) 896-8193
- **Mailing address:** 4912 ALBEMARLE RD, CHARLOTTE, NC 28205-6618
- **Mailing address phone:** (980) 229-3722
- **Mailing address fax:** (704) 896-8193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 3547 | NC | Yes |

## Other

- **Enumeration date:** 09/29/2012
- **Last updated:** 09/29/2012