Provider Demographics
NPI:1023416880
Name:MAYO, CHARLES (MSCP, LPC, LAC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:MAYO
Suffix:
Gender:M
Credentials:MSCP, LPC, LAC
Other - Prefix:MR
Other - First Name:CHARLES
Other - Middle Name:D
Other - Last Name:MAYO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHARLES D MAYO LPC,
Mailing Address - Street 1:5800 ONE PERKINS PLAZA
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808
Mailing Address - Country:US
Mailing Address - Phone:185-072-3970
Mailing Address - Fax:
Practice Address - Street 1:5800 ONE PERKINS PLAZA
Practice Address - Street 2:SUITE 5B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-8400
Practice Address - Country:US
Practice Address - Phone:185-072-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLAT-400101YA0400X
LA1506101YA0400X
WYLPC-2099101YM0800X
LALPC6411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)