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Individual

CHARLES ALLEN AVERA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
104 MAXWELL RD, CHAPEL HILL, NC 27517-4042
(919) 923-3814
Mailing address
104 MAXWELL RD, CHAPEL HILL, NC 27517-4042
(919) 923-3814

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8383
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12454514
CAQH
05
6115063
NC
Enumeration date
09/02/2012
Last updated
09/13/2013
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