Provider Demographics
NPI:1316291248
Name:MUHAMMED, CHARNETT (CHARNETT MUHAMMED)
Entity type:Individual
Prefix:
First Name:CHARNETT
Middle Name:
Last Name:MUHAMMED
Suffix:
Gender:F
Credentials:CHARNETT MUHAMMED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 SESSOMS ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-6293
Mailing Address - Country:US
Mailing Address - Phone:910-484-0472
Mailing Address - Fax:
Practice Address - Street 1:742 SESSOMS ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-6293
Practice Address - Country:US
Practice Address - Phone:910-484-0472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2152-A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)