Provider Demographics
NPI:1629706148
Name:ROSENBERG, CHARLOTTE (LCMHCA, LCAS, CADC)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LCMHCA, LCAS, CADC
Other - Prefix:MS
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:910-343-0145
Mailing Address - Fax:910-341-5779
Practice Address - Street 1:615 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6431
Practice Address - Country:US
Practice Address - Phone:910-343-0145
Practice Address - Fax:910-341-5779
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17936101YM0800X, 101YP2500X
NCLCAS-24188101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional