Organization
MENTABLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMELLIA DOUGLAS (OWNER/PROVIDER)
(877) 306-1683
Entity
Organization
Contact information
Practice address
8401 MEDICAL PLAZA DR STE 350, CHARLOTTE, NC 28262-8700
(980) 223-4566
(980) 500-1522
Mailing address
8401 MEDICAL PLAZA DR STE 350, CHARLOTTE, NC 28262-8700
(877) 306-1683
(980) 500-1522
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/18/2024
Last updated
06/03/2026
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