Provider Demographics
NPI:1902328230
Name:LADAY, CHARLES H
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:H
Last Name:LADAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5104 WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77016
Mailing Address - Country:US
Mailing Address - Phone:713-253-5492
Mailing Address - Fax:713-686-9413
Practice Address - Street 1:5104 WEAVER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77016
Practice Address - Country:US
Practice Address - Phone:713-253-5492
Practice Address - Fax:713-686-9413
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74266101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74266OtherLPC
TX760464214OtherTAX ID