Organization
LAKESIDE ABA NC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAMS PSYD (CEO)
(213) 435-9423
Entity
Organization
Contact information
Practice address
2015 AYRSLEY TOWN BLVD, STE 202, CHARLOTTE, NC 28273
(213) 435-9423
Mailing address
1500 S DOHENY DR, LOS ANGELES, CA 90035-3211
(213) 435-9423
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
07/01/2025
Last updated
10/24/2025
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