Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Conversion Therapeutic Services Inc

Organization Multi-Specialty Clinic/Center · NPI 1245094192

Conversion Therapeutic Services Inc is a Multi-Specialty Clinic/Center in Charlotte, North Carolina. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11535 Carmel Commons Blvd Ste 102
Charlotte, NC 28226-5314
Phone: (704) 910-1788
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X

Record details

NPI number1245094192
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tenicia Washington — Owner · (443) 531-1988
NPI enumeratedFebruary 12, 2024
Last updated in NPPESOctober 8, 2024
Certification dateOctober 8, 2024
Mailing address848 Kathy Dianne Dr, Indian Land, SC 29707-6898

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