Healthcare Provider Details

I. General information

NPI: 1851762017
Provider Name (Legal Business Name): CHRISTINE CAUWELS LCPC, LMHC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E HATTERLEIGH AVE
HILLSBOROUGH NC
27278-6002
US

IV. Provider business mailing address

611 E HATTERLEIGH AVE
HILLSBOROUGH NC
27278-6002
US

V. Phone/Fax

Practice location:
  • Phone: 563-676-0816
  • Fax:
Mailing address:
  • Phone: 563-676-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15701
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180006939
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: