Individual
DR. CHARLEENE VIRGINIA NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2270 HENDERSONVILLE RD, STE 1, ARDEN, NC 28704-2734
(828) 778-4721
Mailing address
555 LANCASTER RD, HENDERSONVILLE, NC 28792
(828) 778-4721
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
AD003667
NC
103TA0400X
Addiction (Substance Use Disorder) Psychologist
LCAS 1142
NC
103TC0700X
Clinical Psychologist
Primary
0893
NC
Other
Enumeration date
02/19/2008
Last updated
04/17/2018
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