Provider Demographics
NPI:1053905083
Name:HIGHTOWER, CHARLENE C (PHD, LCSW-A, LCAS-A)
Entity type:Individual
Prefix:MS
First Name:CHARLENE
Middle Name:C
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:PHD, LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 SEDGEWICK RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-4705
Mailing Address - Country:US
Mailing Address - Phone:336-837-9722
Mailing Address - Fax:
Practice Address - Street 1:6003 SEDGEWICK RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-4705
Practice Address - Country:US
Practice Address - Phone:336-837-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24334101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)