Provider Demographics
NPI:1801136189
Name:HERNDON, CHRISTOPHER (LCSW, LCAS, CSI)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HERNDON
Suffix:
Gender:M
Credentials:LCSW, LCAS, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLER BOX C-268
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-6977
Practice Address - Street 1:375 SEQUOYAH TRL
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719
Practice Address - Country:US
Practice Address - Phone:828-497-6892
Practice Address - Fax:828-497-6977
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-14842101YA0400X
NCC0079571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)