Organization
CAROLINA BEHAVIORAL HEALTH SERVICES,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES UKAOMA LPC, PSY.D., ICCD-P, (DIRECTOR OF CLINICAL OPERATIONS)
(704) 712-7669
Entity
Organization
Contact information
Practice address
1101 TYVOLA RD, SUITE 304, CHARLOTTE, NC 28217-3515
(704) 712-7669
(704) 264-3031
Mailing address
1101 TYVOLA RD, SUITE 316, CHARLOTTE, NC 28217-3515
(704) 712-7669
(704) 264-3031
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4813
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005825
—
NC
05
—
6102192
—
NC
Enumeration date
03/26/2007
Last updated
11/08/2010
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