Individual provider · Type 1 NPI

Charles Wayne Ellis, CACI, MAC

Addiction (Substance Use Disorder) Counselor · Rock Hill, SC

NPI number 1164763777 Active

Practice location

199 S Herlong Ave
Rock Hill, SC 29732-1186

Call (803) 324-1800 Map

Fax (803) 328-3831

Mailing address

12304 Jacquelyn Ct
Charlotte, NC 28273-9017

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X1211149 (SC)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1164763777

Charles Wayne Ellis, CACI, MAC's National Provider Identifier is 1164763777, issued on Mar 6, 2013. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Rock Hill, SC. The record was last updated on Mar 6, 2013.