Provider Demographics
NPI:1033825070
Name:ATKINSON, CARLEA (LCMHCA)
Entity Type:Individual
Prefix:
First Name:CARLEA
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 WOODINGTON LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-0018
Mailing Address - Country:US
Mailing Address - Phone:336-549-3557
Mailing Address - Fax:
Practice Address - Street 1:1914 BRUNSWICK AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1891
Practice Address - Country:US
Practice Address - Phone:704-910-2055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18456101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health