Provider Demographics
NPI:1700192309
Name:ALDRIDGE, GINGER (MA, LPC, LCAS)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MA, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 PARK RD
Mailing Address - Street 2:SUITE 200-C
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3650
Mailing Address - Country:US
Mailing Address - Phone:704-562-4612
Mailing Address - Fax:
Practice Address - Street 1:5200 PARK RD
Practice Address - Street 2:SUITE 200-C
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3650
Practice Address - Country:US
Practice Address - Phone:704-562-4612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7906101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional