Healthcare Provider Details

I. General information

NPI: 1023912664
Provider Name (Legal Business Name): CHASITY CHARTESE BROOKS LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N TRADE ST STE 206
MATTHEWS NC
28105-9433
US

IV. Provider business mailing address

250 N TRADE ST STE 206
MATTHEWS NC
28105-9433
US

V. Phone/Fax

Practice location:
  • Phone: 980-202-2288
  • Fax:
Mailing address:
  • Phone: 980-202-2288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23543
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: