Provider Demographics
NPI:1730553967
Name:HOPKINS, CHANTELLE RENEE (LCMHC, LCAS-A)
Entity type:Individual
Prefix:
First Name:CHANTELLE
Middle Name:RENEE
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LCMHC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 TERAVISTA WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-9310
Mailing Address - Country:US
Mailing Address - Phone:919-646-1950
Mailing Address - Fax:919-800-3245
Practice Address - Street 1:2443 LYNN RD STE 112
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6759
Practice Address - Country:US
Practice Address - Phone:919-646-1950
Practice Address - Fax:919-800-3245
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-27
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-25-274101YA0400X
NCA11647101YM0800X
NC11647101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health