Provider Demographics
NPI:1861535163
Name:TABER, CHARLOTTE MARIE (MS LPC LMFT)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:MARIE
Last Name:TABER
Suffix:
Gender:F
Credentials:MS LPC LMFT
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:MARIE
Other - Last Name:PRINGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1555 MEADOW GLEN
Mailing Address - Street 2:
Mailing Address - City:ADKINS
Mailing Address - State:TX
Mailing Address - Zip Code:78101
Mailing Address - Country:US
Mailing Address - Phone:830-216-2998
Mailing Address - Fax:830-216-2998
Practice Address - Street 1:1104 D STREET
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114
Practice Address - Country:US
Practice Address - Phone:210-241-3998
Practice Address - Fax:830-216-2998
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17515LPC101YP2500X
TX5147LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7027LCOtherBLUE CROSS BLUE SHIELD