Provider Demographics
NPI:1255752531
Name:LENAHAN, CHARLES ARTHUR (MA,LPC, NCC, CSOTS)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ARTHUR
Last Name:LENAHAN
Suffix:
Gender:
Credentials:MA,LPC, NCC, CSOTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1953
Mailing Address - Country:US
Mailing Address - Phone:678-472-7347
Mailing Address - Fax:
Practice Address - Street 1:921 W JONATHON DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-3126
Practice Address - Country:US
Practice Address - Phone:784-727-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-39126101YP2500X
GALPC009358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional