Provider Demographics
NPI:1417466285
Name:CHARLOTTE COUNSELING ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CHARLOTTE COUNSELING ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PROFESSIONAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCAS, CSAT-C
Authorized Official - Phone:980-263-9608
Mailing Address - Street 1:5970 FAIRVIEW RD STE 414
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3179
Mailing Address - Country:US
Mailing Address - Phone:980-263-9608
Mailing Address - Fax:980-498-7881
Practice Address - Street 1:5970 FAIRVIEW RD STE 414
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3179
Practice Address - Country:US
Practice Address - Phone:980-263-9608
Practice Address - Fax:980-498-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1648101YA0400X
NC7447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty