Individual
THOMAS GLENN AUSTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CSAC, CCS
Contact information
Practice address
5601 EXECUTIVE CENTER DR, SUITE 101, CHARLOTTE, NC 28212-8841
(704) 561-0920
(704) 561-0851
Mailing address
2030 BONANZA RD, MONROE, NC 28110-8969
(704) 561-0920
(704) 561-0851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6110525
—
NC
Enumeration date
05/04/2006
Last updated
07/09/2007
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