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NPI Code Detail

MEDICARE: CHARLES ADAM CLUCHEY LPC

MEDICARE:   CHARLES ADAM CLUCHEY  LPC
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
1101YP2500XProfessional Counselor70589TX

General Provider Information

NPI Number : 1588049142
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES ADAM CLUCHEY LPC
Provider Business Mailing Address
First Line : 3939 W GREEN OAKS BLVD STE 206
Second Line :
City : ARLINGTON
State : TX
Zip : 76016-2793
Country : US
Telephone Number : 214-608-0701
Fax Number :
Provider Business Practice Location Address
First Line : 3939 W GREEN OAKS BLVD STE 206
Second Line :
City : ARLINGTON
State : TX
Zip : 76016-2793
Country : US
Telephone Number : 214-608-0701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2015
Last Update Date : 10/10/2019

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Directions to “ CHARLES ADAM CLUCHEY LPC” Practice Location

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