Individual
COREY CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-3384
Mailing address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
(704) 376-3384
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22730
NC
101YP2500X
Professional Counselor
A12439
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22730
LCASA
NC
01
—
A12439
LPCA
NC
Enumeration date
09/21/2016
Last updated
09/21/2016
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