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General NPI Number Information
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NPI Number | 1528163029
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Entity Type | Individual
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Provider Name | CHARLIE MCMORDIE LPC
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7000 W 45TH AVE
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City | AMARILLO
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State | TX
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Zip | 79109-5088
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Country | US
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Telephone | 806-352-5474
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Fax | 806-352-3797
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Provider Business Mailing Address
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Address Line | PO BOX 50360
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City | AMARILLO
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State | TX
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Zip | 79159-0360
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Country | US
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Telephone | 806-351-1560
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Fax | 806-351-0343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 16233
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 16233
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License Number State | TX
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