Individual
COURTNEY NICOLE FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
5700 EXECUTIVE CENTER DR STE 200, CHARLOTTE, NC 28212-8833
(800) 320-4157
(704) 494-7796
Mailing address
PO BOX 1, BARIUM SPRINGS, NC 28010-0001
(704) 832-2200
(704) 838-1541
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P015459
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P015459
LICENSE
NC
Enumeration date
02/09/2021
Last updated
02/09/2021
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