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WILLIE SHINE CSAC
NPI 1407253123
Counselor - Addiction (Substance Use Disorder) in Charlotte, NC

Active since November 24, 2014
7925 NORTH TRYON ST, CHARLOTTE, NC 28262(704) 612-0566(704) 498-4846 Get Directions Write a Review

NPPES record last updated: November 24, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Willie Shine Csac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIE SHINE CSAC (NPI 1407253123) is an individual addiction (substance use disorder) provider in Charlotte, North Carolina, licensed in North Carolina (CSAC-20389) and active in the NPI registry since November 2014.

NPPES Registry Identity

NPI1407253123
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameWILLIE SHINECredential: CSAC
Location Address7925 NORTH TRYON STCharlotte, NC 28262
Mailing Address7925 N Tryon StCharlotte, NC 28262-3408 · (980) 612-0566 · Fax (704) 498-4846
Phone(704) 612-0566
Fax(704) 498-4846
Sole ProprietorYes
Enumeration DateNovember 24, 2014
✔ NPI 1407253123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NC · CSAC-20389
7925 NORTH TRYON ST, Charlotte, NC 28262
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Other Names 1

Professional Name (2)Mr. Willie Shine Csac

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willie Shine's NPI number?

The NPI number for Willie Shine is 1407253123. It was assigned to this individual provider in the NPPES registry on November 24, 2014.

Where is Willie Shine located?

Willie Shine practices at 7925 North Tryon St, Charlotte, NC 28262. The listed phone number is (704) 612-0566.

What is Willie Shine's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Willie Shine was last updated on November 24, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.