Individual
MR. CHARLES THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC, LCAS, CS
Contact information
Practice address
11400 CELANDINE CT, CHARLOTTE, NC 28213-9265
(704) 509-6787
Mailing address
11400 CELANDINE CT, CHARLOTTE, NC 28213-9265
(704) 509-6787
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1311
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
533
NC
101YM0800X
Mental Health Counselor
4447
MA
101YM0800X
Mental Health Counselor
S7046
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104116
—
NC
Enumeration date
06/04/2008
Last updated
09/14/2011
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