Ethan Lee Beaver, MA, LCAS-A - Counselor in Charlotte, NC

Ethan Lee Beaver, MA, LCAS-A is a Counselor - Addiction (substance Use Disorder) based in Charlotte, North Carolina. Ethan Lee Beaver is licensed to practice in North Carolina (license number LCAS-29534) and his current practice location is 616 Colonnade Dr, Charlotte, North Carolina. He can be reached at his office (for appointments etc.) via phone at (704) 273-3942.

NPI number for Ethan Lee Beaver is 1003689563 and his current mailing address is 284 Executive Park Dr Ste 100, Concord, North Carolina. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003689563.

Contact Information

Ethan Lee Beaver, MA, LCAS-A
616 Colonnade Dr,
Charlotte, NC 28205-6827
(704) 273-3942
(704) 749-2305

Healthcare Provider's Profile

Full NameEthan Lee Beaver
GenderMale
SpecialityCounselor - Addiction (substance Use Disorder)
Location616 Colonnade Dr, Charlotte, North Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003689563
  • Provider Enumeration Date: 11/06/2023
  • Last Update Date: 11/06/2023

Medical Identifiers

Medical identifiers for Ethan Lee Beaver such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003689563NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) LCAS-29534 (North Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Lee Beaver is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ethan Lee Beaver, MA, LCAS-A
284 Executive Park Dr Ste 100,
Concord, NC 28025-1833

Ph: (704) 939-1100
Ethan Lee Beaver, MA, LCAS-A
616 Colonnade Dr,
Charlotte, NC 28205-6827

Ph: (704) 273-3942

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Counselor in Charlotte, NC

Dr. Jeff Randall Mishoe, D.MIN.
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Phone: 704-344-1100    Fax: 704-344-1100
Allegra Shonta Cooper, LCMHC
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Practice Location: 6324 Fairview Rd Ste 460, Charlotte, NC 28210
Phone: 980-302-8611    Fax: 980-302-8624
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Phone: 704-332-0081    Fax: 704-332-0085
Dr. Terri Lynn Tilford, EDD
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Practice Location: 10130 Mallard Creek Rd Ste 300, Charlotte, NC 28262
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Medicare: Not Enrolled in Medicare
Practice Location: 5200 Park Rd Ste 218b, Charlotte, NC 28209
Phone: 866-700-1606    Fax: 866-338-5921

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