Provider Demographics
NPI:1326528464
Name:CHARNIN, LEIA ANN (PHD, LP, HSP-P)
Entity Type:Individual
Prefix:DR
First Name:LEIA
Middle Name:ANN
Last Name:CHARNIN
Suffix:
Gender:F
Credentials:PHD, LP, HSP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 PIEDMONT ROW DR S
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28287-3884
Mailing Address - Country:US
Mailing Address - Phone:704-552-0116
Mailing Address - Fax:
Practice Address - Street 1:6060 PIEDMONT ROW DR S STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287
Practice Address - Country:US
Practice Address - Phone:704-552-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5170103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling