Individual
MCDERMOTT WILTON CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCMHCA, LCASA
Contact information
Practice address
4922 ALBEMARLE RD, CHARLOTTE, NC 28205-6618
(704) 510-4285
Mailing address
PO BOX 1352, SALISBURY, NC 28145-1352
(980) 330-8470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-25057
NC
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
A14619
NC
Other
Enumeration date
02/20/2019
Last updated
04/14/2022
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