Provider Demographics
NPI:1942459813
Name:MCCRORIE, LOUISE MATTOCKS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:MATTOCKS
Last Name:MCCRORIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13320 KENSAL GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7806
Mailing Address - Country:US
Mailing Address - Phone:704-588-9153
Mailing Address - Fax:704-336-7429
Practice Address - Street 1:720 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2884
Practice Address - Country:US
Practice Address - Phone:704-432-0664
Practice Address - Fax:704-336-7429
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC006164101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health