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General NPI Number Information
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NPI Number | 1073969689
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Entity Type | Organization
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Legal Business Name | CHARLOTTE HILER EASLEY LCSW, LLC
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 118 CONSTITUTION ST STE 130
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City | LEXINGTON
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State | KY
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Zip | 40507-2111
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Country | US
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Telephone | 859-806-8280
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11770
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City | LEXINGTON
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State | KY
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Zip | 40577-1770
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Country | US
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Telephone | 859-806-8280
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MRS. CHARLOTTE HILER EASLEY
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Credential | LCSW
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Telephone | 859-806-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4056
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License Number State | KY
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