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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
9258 ESSEN LN, CHARLOTTE, NC 28210-7770
(602) 487-2146
Mailing address
101 W QUARTZ ST # 3B, BUTTE, MT 59701-9200
(602) 487-2146

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
13288
NC
101YP2500X
Professional Counselor
20038
AZ
101YP2500X
Professional Counselor
Primary
77065
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518478759
1518478759
SC
Enumeration date
10/16/2017
Last updated
07/23/2025
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