Provider Demographics
NPI:1922274414
Name:CHARLESPOINTE COUNSELING LLC
Entity Type:Organization
Organization Name:CHARLESPOINTE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPC
Authorized Official - Phone:636-947-2325
Mailing Address - Street 1:820 S MAIN ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-3306
Mailing Address - Country:US
Mailing Address - Phone:636-947-2325
Mailing Address - Fax:636-947-5941
Practice Address - Street 1:820 S MAIN ST
Practice Address - Street 2:SUITE 307
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-3306
Practice Address - Country:US
Practice Address - Phone:636-947-2325
Practice Address - Fax:636-947-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002032132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty