Individual
CHARLES DOUGLAS PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, ALPS
Contact information
Practice address
115 PRIVATE ROAD 977, PEDRO, OH 45659-8608
(740) 534-1386
Mailing address
115 PRIVATE ROAD 977, PEDRO, OH 45659-8608
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
276481
WV
101Y00000X
Counselor
C.1801567
OH
101YM0800X
Mental Health Counselor
123
WV
101YP2500X
Professional Counselor
Primary
2158
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
Enumeration date
03/05/2012
Last updated
03/18/2023
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