Provider Demographics
NPI:1306568480
Name:NOLES, CHARLES (LCMHCA, NCC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:NOLES
Suffix:
Gender:M
Credentials:LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 YOPP RD # 214439
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-3595
Mailing Address - Country:US
Mailing Address - Phone:910-939-8461
Mailing Address - Fax:
Practice Address - Street 1:420 DURHAM STATION DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-3400
Practice Address - Country:US
Practice Address - Phone:269-519-8726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health