Healthcare Provider Details

I. General information

NPI: 1508772039
Provider Name (Legal Business Name): ANNA ZOPHIA SERRATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ZOPHIA SERRATE LCMHCA, NCC

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LATROBE DR STE 530
CHARLOTTE NC
28211-1664
US

IV. Provider business mailing address

3408 OAK TREE TRL
MATTHEWS NC
28105-4455
US

V. Phone/Fax

Practice location:
  • Phone: 980-393-0303
  • Fax:
Mailing address:
  • Phone: 980-286-7125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22772
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: