Provider Demographics
NPI:1306187075
Name:ARENAS VELASQUEZ, SERGIO ANDRES (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:ANDRES
Last Name:ARENAS VELASQUEZ
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:SERGIO
Other - Middle Name:ANDRES
Other - Last Name:ARENAS VELASQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9408 COPPER HILL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0321
Mailing Address - Country:US
Mailing Address - Phone:347-821-2041
Mailing Address - Fax:
Practice Address - Street 1:10801 MONROE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:704-237-4240
Practice Address - Fax:704-841-3889
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005441101YM0800X
NC13966101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health