Provider Demographics
NPI:1134598790
Name:FLINT, PHUONG MINH (MA, LCMHC)
Entity type:Individual
Prefix:MRS
First Name:PHUONG
Middle Name:MINH
Last Name:FLINT
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:MISS
Other - First Name:PHUONG
Other - Middle Name:MINH
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, NCC, LCMHC
Mailing Address - Street 1:9716 REA RD STE B1310
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6789
Mailing Address - Country:US
Mailing Address - Phone:704-412-8491
Mailing Address - Fax:704-885-2207
Practice Address - Street 1:9019 HOLLAND PARK LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2725
Practice Address - Country:US
Practice Address - Phone:704-412-8491
Practice Address - Fax:704-885-2207
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11756101YM0800X
NC11756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health