Provider Demographics
NPI:1699750109
Name:AUSHERMAN, CHARLES (LCSW, MSW)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:AUSHERMAN
Suffix:
Gender:M
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:UNIVERSITY PSYCHIATRIC CENTER
Practice Address - Street 2:DOCTORS PARK #6
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-744-2404
Practice Address - Fax:252-744-2419
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0023081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002383Medicaid
NC13294OtherBCBS NC
NC800013446OtherRAILROAD MEDICARE
NCP65227Medicare UPIN
NC2874777AMedicare ID - Type Unspecified