Provider Demographics
NPI:1992697908
Name:HUGGINS, CHANNING DENESHIA
Entity type:Individual
Prefix:MRS
First Name:CHANNING
Middle Name:DENESHIA
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7368 OTTER BRANCH CT NE
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-7073
Mailing Address - Country:US
Mailing Address - Phone:910-859-3136
Mailing Address - Fax:
Practice Address - Street 1:3120 RUTLAND RD SE
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-7546
Practice Address - Country:US
Practice Address - Phone:910-859-3136
Practice Address - Fax:910-859-3136
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 171M00000X, 225C00000X
NC175T00000X
NCCERTIFICATION101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor