Individual
CHANEL PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14729 4TH ST UNIT 221, LAUREL, MD 20707-4014
(704) 559-9830
Mailing address
5704 LINDLEY CRESCENT DR, INDIAN TRAIL, NC 28079-4238
(704) 221-2034
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-272922
NC
101YM0800X
Mental Health Counselor
Primary
17960
NC
101YM0800X
Mental Health Counselor
LC16318
MD
101YP2500X
Professional Counselor
Primary
A17960
NC
Other
Enumeration date
04/19/2022
Last updated
03/04/2026
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