Provider Demographics
NPI:1245249838
Name:FINN, CHARLES C (LPC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:C
Last Name:FINN
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 1:400 E BURWELL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4338
Mailing Address - Country:US
Mailing Address - Phone:540-387-3105
Mailing Address - Fax:540-387-3653
Practice Address - Street 1:400 E BURWELL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4338
Practice Address - Country:US
Practice Address - Phone:540-387-3105
Practice Address - Fax:540-387-3653
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
089929OtherSENTARA/SOUTHERN HEALTH
395225OtherANTHEM/ANTHEM HEALTHKEEP
208998OtherVALUE OPTIONS
5408156OtherVA PREMIER
5596593OtherAETNA
375881OtherMAMSI, MDIPA