Provider Demographics
NPI:1053189845
Name:HUNTER, CHARLES LARRY II (LGPC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:LARRY
Last Name:HUNTER
Suffix:II
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 REGENCY PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-3088
Mailing Address - Country:US
Mailing Address - Phone:240-427-3554
Mailing Address - Fax:
Practice Address - Street 1:5010 REGENCY PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3088
Practice Address - Country:US
Practice Address - Phone:240-427-3554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14450106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist