Provider Demographics
NPI:1508405804
Name:WESSEL, CHARLES W (LPCC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:WESSEL
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:WILLIAM
Other - Last Name:WESSEL
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:4730 BECKNER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4730 BECKNER RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3691
Practice Address - Country:US
Practice Address - Phone:505-989-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296383101YP2500X
LA9972101YP2500X
ORC8448101YP2500X
TX69341101YP2500X
NMCTB-2025-0224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional