Provider Demographics
NPI:1467658427
Name:COMBS, CHARLES EDWARD JR (LPC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:EDWARD
Last Name:COMBS
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:ED
Other - Middle Name:
Other - Last Name:COMBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1030 E BASELINE RD
Mailing Address - Street 2:SUITE 105 PMB 1041
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-456-6634
Mailing Address - Fax:480-924-5255
Practice Address - Street 1:3030 SO RURAL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-456-6634
Practice Address - Fax:480-924-5255
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC1004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional