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Individual

CHRISTINE HOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA LPC LCAS CCS

Contact information

Practice address
4607 CHARLOTTE HWY STE 16, LAKE WYLIE, SC 29710-8149
(803) 620-5777
Mailing address
4607 CHARLOTTE HWY STE 16, LAKE WYLIE, SC 29710-8149
(803) 620-5777

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23012
NC
101YM0800X
Mental Health Counselor
Primary
12716
NC
101YP2500X
Professional Counselor
12716
NC

Other

Enumeration date
07/26/2016
Last updated
07/06/2020
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