Provider Demographics
NPI:1770387045
Name:CHALLITA, ELIE ANTOINE (MA, LCMHCA, LCAS-A)
Entity type:Individual
Prefix:MR
First Name:ELIE
Middle Name:ANTOINE
Last Name:CHALLITA
Suffix:
Gender:M
Credentials:MA, LCMHCA, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 ANN ST
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-9220
Mailing Address - Country:US
Mailing Address - Phone:704-308-7465
Mailing Address - Fax:
Practice Address - Street 1:2005 FLINT LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3334
Practice Address - Country:US
Practice Address - Phone:980-522-8247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30621101YA0400X
SC10337101YP2500X
NCA21253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional