Provider Demographics
NPI:1730424169
Name:ASHHALI, MALIK (LCSW, LCAS, MAC, CSI)
Entity type:Individual
Prefix:
First Name:MALIK
Middle Name:
Last Name:ASHHALI
Suffix:
Gender:M
Credentials:LCSW, LCAS, MAC, CSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 MILTON RD STE 233
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3782
Mailing Address - Country:US
Mailing Address - Phone:704-891-3481
Mailing Address - Fax:855-299-3536
Practice Address - Street 1:3126 MILTON RD STE 233
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3782
Practice Address - Country:US
Practice Address - Phone:704-817-9120
Practice Address - Fax:855-299-3536
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-3040101YA0400X
SCLAC768101YA0400X
SC124731041C0700X
NCC0099661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)