Provider Demographics
NPI:1033788666
Name:HUNTER, CHARMAYNE (MA, LCDC)
Entity Type:Individual
Prefix:
First Name:CHARMAYNE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MA, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18627 ATASCA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1453
Mailing Address - Country:US
Mailing Address - Phone:281-608-7304
Mailing Address - Fax:
Practice Address - Street 1:18627 ATASCA OAKS DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1453
Practice Address - Country:US
Practice Address - Phone:281-608-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11180101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)