Provider Demographics
NPI:1952324592
Name:HOLTON, CHARLES A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:A
Last Name:HOLTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 EUROPA DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2357
Mailing Address - Country:US
Mailing Address - Phone:919-929-1227
Mailing Address - Fax:919-968-2575
Practice Address - Street 1:4201 LAKE BOONE TRL
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7512
Practice Address - Country:US
Practice Address - Phone:919-785-0384
Practice Address - Fax:919-785-0038
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCC000273104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker