Individual
TINA LATHAN BOYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A, LCMHCA
Contact information
Practice address
5200 PARK RD STE 218B, CHARLOTTE, NC 28209-3650
(866) 700-1606
(866) 338-5921
Mailing address
5200 PARK RD STE 218B, CHARLOTTE, NC 28209-3650
(866) 700-1606
(866) 338-5921
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
20469
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20469
NC
101YM0800X
Mental Health Counselor
A17068
NC
101YP2500X
Professional Counselor
A17068
NC
Other
Enumeration date
04/18/2019
Last updated
02/14/2022
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