Individual
CHARMAILE PENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
705 CUMBERLAND ST, FAYETTEVILLE, NC 28301-7020
(910) 483-5986
Mailing address
1128 ANTHEM LN UNIT 9101, FAYETTEVILLE, NC 28311-0043
(910) 813-7304
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-25843
NC
1041C0700X
Clinical Social Worker
P011284
NC
1041C0700X
Clinical Social Worker
Primary
P015678
NC
Other
Enumeration date
05/10/2017
Last updated
03/25/2021
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