MEDICARE: FAITH HOUCK-WYLIE LCMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	A22542	NC

General Provider Information

NPI Number	:	1225980600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAITH HOUCK-WYLIE LCMHCA

Provider Business Mailing Address
First Line	:	4012 PARK RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-2377
Country	:	US
Telephone Number	:	704-332-4834
Fax Number	:	704-372-9653

Provider Business Practice Location Address
First Line	:	31 S TALBERT BLVD # 301
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-4025
Country	:	US
Telephone Number	:	980-281-0974
Fax Number	:	336-232-1368

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	03/30/2026

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