Provider Demographics
NPI:1942231246
Name:BATTAILE, WILLIAM GEORGE (LPC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:BATTAILE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8353 MERRYVALE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-9097
Mailing Address - Country:US
Mailing Address - Phone:704-488-1294
Mailing Address - Fax:866-384-7493
Practice Address - Street 1:8353 MERRYVALE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-9097
Practice Address - Country:US
Practice Address - Phone:704-488-1294
Practice Address - Fax:866-384-7493
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102859Medicaid