Individual
AHMAD BLAKENEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
4401 E INDEPENDENCE BLVD STE 208-G, CHARLOTTE, NC 28205-7485
(704) 208-8038
Mailing address
4401 E INDEPENDENCE BLVD STE 208-G, CHARLOTTE, NC 28205-7485
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS27033
NC
101YM0800X
Mental Health Counselor
A22132
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A22132
—
NC
01
—
LCAS27033
STATE LICENSE
NC
Enumeration date
05/20/2021
Last updated
10/08/2025
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