Provider Demographics
NPI:1578680963
Name:MCLAUGHLIN, ALTHIA GAMBLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALTHIA
Middle Name:GAMBLE
Last Name:MCLAUGHLIN
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 1:3431 ARBORETUM VW
Mailing Address - Street 2:UNIT A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-9007
Mailing Address - Country:US
Mailing Address - Phone:704-817-7991
Mailing Address - Fax:
Practice Address - Street 1:6425 BANNINGTON RD
Practice Address - Street 2:A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1339
Practice Address - Country:US
Practice Address - Phone:704-763-8025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103476Medicaid