Provider Demographics
NPI:1477113496
Name:EVERETT, CHARITY (LPC)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:EVERETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD STE 804
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4414
Mailing Address - Country:US
Mailing Address - Phone:856-866-6331
Mailing Address - Fax:856-772-9674
Practice Address - Street 1:1000 WHITE HORSE RD STE 804
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4414
Practice Address - Country:US
Practice Address - Phone:856-866-6331
Practice Address - Fax:856-772-9674
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00620000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional