Avera, Charles Allen

Avera, Charles Allen is an sole proprietor health care provider with primary practice located at 104 Maxwell Rd , Chapel Hill NC 27517-4042. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Avera, Charles Allen can be contacted via phone (919) 923-3814.

Contact Information

Primary practice address
104 Maxwell Rd Chapel Hill NC 27517-4042
Phone: (919) 923-3814
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 8383 North Carolina

Profile Details

NPI number 1407105786
LBN Legal business name Avera, Charles Allen
Credentials MA, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 2nd, 2012
Last updated Sep 13th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407105786 NPPES
Other 12454514 CAQH
MEDICAID 6115063 CAQH

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