Individual
DR. CHARLES VANWAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DST, LMFT
Contact information
Practice address
3733 NATIONAL DR, SUITE 221, RALEIGH, NC 27612-4065
(919) 783-5775
(919) 783-5775
Mailing address
3733 NATIONAL DR, SUITE 221, RALEIGH, NC 27612-4065
(919) 783-5775
(919) 783-5775
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84688
BCBS PIN#
NC
Enumeration date
11/30/2006
Last updated
07/08/2007
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