Provider Demographics
NPI:1306817242
Name:AREY, JOHN JR
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:AREY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 EDENDERRY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-3806
Mailing Address - Country:US
Mailing Address - Phone:704-375-5354
Mailing Address - Fax:704-375-3069
Practice Address - Street 1:1801 E. 5TH ST. STE 110
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2472
Practice Address - Country:US
Practice Address - Phone:704-375-5354
Practice Address - Fax:704-375-3069
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0059101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC136CEOtherBLUE CROSS/BLUE SHIELD