person
Mr. Detraveus Ingram, CADC-R
Addiction (Substance Use Disorder) Counselor in Pinehurst, North Carolina
NPI 1225786296

Detraveus Ingram is an Addiction (Substance Use Disorder) Counselor based in Carthage, NC and is specialized in Addiction (Substance Use Disorder). Detraveus Ingram practices in Pinehurst, NC and has the professional credentials of CADC-R. The NPI Number for Detraveus Ingram is 1225786296 and holds a License No. CADC-27212 (North Carolina).

The current practice location address for Detraveus Ingram is 20 Page Dr, Pinehurst, NC and can be reached out via phone at 910-235-9090 and via fax at 910-235-9093.

Location: 20 Page Dr, Pinehurst, NC, 28327-9245
person
Provider Profile Details
NPI Number
1225786296
Provider Name
Detraveus Ingram
Credential
CADC-R
Provider Entity Type
Individual
Gender
Male
Address
20 Page Dr, Pinehurst, NC, 28327-9245
Phone Number
910-235-9090
Fax Number
910-235-9093
Provider Enumeration Date
03/17/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
20 Page Dr
City
State
Zip
28374-8847
Phone Number
910-235-9090
Fax Number
910-235-9093
person
Provider Business Mailing Address Details
Address
20 Page Dr
City
State
Zip
28374-8847
Phone Number
910-235-9090
Fax Number
910-235-9093
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CADC-27212 (North Carolina)
Definition
Definition to come...
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