| Charles Community Counseling Center Pllc | |
|
1941 Day Break Dr Lancaster TX 75146-4949 | |
| (469) 243-8879 | |
| Not Available |
| Full Name | Charles Community Counseling Center Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1941 Day Break Dr, Lancaster, Texas |
| Authorized Official Name and Position | Lekeesha Lequan Charles (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9724155177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Community Counseling Center Pllc Po Box 191591 Dallas TX 75219-8502 Ph: (972) 415-5177 | Charles Community Counseling Center Pllc 1941 Day Break Dr Lancaster TX 75146-4949 Ph: (469) 243-8879 |
| NPI Number | 1265937924 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 1658626155 |
|---|---|
| Medicare Enrollment ID | O20180625003376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265937924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 40801 (Texas) | Primary |
| Provider Name | Lekeesha Lequan Charles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013412774 PECOS PAC ID: 3476808973 Enrollment ID: I20180625003457 |
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