Provider Demographics
NPI:1790343036
Name:NATASHA OATES
Entity Type:Organization
Organization Name:NATASHA OATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:OATES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, EDS, LPC
Authorized Official - Phone:704-820-4293
Mailing Address - Street 1:1235 EAST BLVD # E168
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5870
Mailing Address - Country:US
Mailing Address - Phone:704-820-4293
Mailing Address - Fax:704-830-0520
Practice Address - Street 1:801 E MOREHEAD ST STE 105
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2730
Practice Address - Country:US
Practice Address - Phone:704-820-4293
Practice Address - Fax:704-830-0520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-02
Last Update Date:2019-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10054OtherPROFESSIONAL COUNSELOR LICENSE