person
Ethan Lee Beaver, MA,LCAS-A
Addiction (Substance Use Disorder) Counselor in Charlotte, North Carolina
NPI 1003689563

Ethan Lee Beaver is an Addiction (Substance Use Disorder) Counselor based in Concord, NC and is specialized in Addiction (Substance Use Disorder). Ethan Lee Beaver practices in Charlotte, NC and has the professional credentials of MA,LCAS-A. The NPI Number for Ethan Lee Beaver is 1003689563 and holds a License No. LCAS-29534 (North Carolina).

The current practice location address for Ethan Lee Beaver is 616 Colonnade Dr, Charlotte, NC and can be reached out via phone at 704-273-3942 and via fax at 704-749-2305.

Location: 616 Colonnade Dr, Charlotte, NC, 28025-1833
person
Provider Profile Details
NPI Number
1003689563
Provider Name
Ethan Lee Beaver
Credential
MA,LCAS-A
Provider Entity Type
Individual
Gender
Male
Address
616 Colonnade Dr, Charlotte, NC, 28025-1833
Phone Number
704-273-3942
Fax Number
704-749-2305
Provider Enumeration Date
11/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
616 Colonnade Dr
City
State
Zip
28205-6827
Phone Number
704-273-3942
Fax Number
704-749-2305
person
Provider Business Mailing Address Details
Address
616 Colonnade Dr
City
State
Zip
28205-6827
Phone Number
704-273-3942
Fax Number
704-749-2305
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
LCAS-29534 (North Carolina)
Definition
Definition to come...
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