Provider Demographics
NPI:1992500029
Name:BOONE, CHARLOTTE (LCSWA)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22743 GILLIS RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28351-9225
Mailing Address - Country:US
Mailing Address - Phone:910-280-6330
Mailing Address - Fax:
Practice Address - Street 1:503 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3615
Practice Address - Country:US
Practice Address - Phone:910-417-4922
Practice Address - Fax:910-417-4923
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0217551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical