Provider Demographics
NPI:1124340302
Name:STRICKLAND, CHARLES C COURTNEY (MSW, LCSW, LCAS, CCS)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:C COURTNEY
Last Name:STRICKLAND
Suffix:
Gender:
Credentials:MSW, LCSW, LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2726
Mailing Address - Country:US
Mailing Address - Phone:504-717-9872
Mailing Address - Fax:
Practice Address - Street 1:606 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:OR
Practice Address - Zip Code:97828-5140
Practice Address - Country:US
Practice Address - Phone:542-426-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1577101YA0400X
NCC0095291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112149Medicaid