Individual
FRANCES ERNESTINE TACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, LCAS, CCS
Contact information
Practice address
1335 ELIZABETH AVE., BELK 3157, CHARLOTTE, NC 28235-5009
(704) 330-6749
(704) 330-6410
Mailing address
PO BOX 35009, BELK 3157, CHARLOTTE, NC 28235-5009
(704) 330-6749
(704) 330-6410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC 2763
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS 675
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102860
—
NC
Enumeration date
09/30/2007
Last updated
09/09/2010
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