Provider Demographics
NPI:1487128013
Name:JAMES, CHARMAINE NICOLE (LPCA)
Entity type:Individual
Prefix:MS
First Name:CHARMAINE
Middle Name:NICOLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 HARCOURT CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-0585
Mailing Address - Country:US
Mailing Address - Phone:910-882-4424
Mailing Address - Fax:
Practice Address - Street 1:2151 SKIBO RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0252
Practice Address - Country:US
Practice Address - Phone:910-689-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-24238101YA0400X
NCA13689101YP2500X
NC13689101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)