Individual
RODERICK ELI BRANSCOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCS, LCAS
Contact information
Practice address
1801 E FIFTH ST STE 212, CHARLOTTE, NC 28204-3400
(704) 661-1429
Mailing address
212 S TRYON ST, SUITE 1060, CHARLOTTE, NC 28281-0001
(704) 496-9757
(704) 496-9757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2592
NC
101YP2500X
Professional Counselor
5079
SC
101YP2500X
Professional Counselor
Primary
7077
NC
Other
Enumeration date
09/14/2007
Last updated
12/02/2014
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