Provider Demographics
NPI:1568742179
Name:MCARTHUR, MARCELLA
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 EXECUTIVE CENTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8869
Mailing Address - Country:US
Mailing Address - Phone:704-227-0627
Mailing Address - Fax:
Practice Address - Street 1:5800 EXECUTIVE CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8869
Practice Address - Country:US
Practice Address - Phone:704-227-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1767101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)