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NPI Code Detail

MEDICARE: ANNA PEARL EATON MED, NCC, LCMHCA

MEDICARE:   ANNA PEARL EATON  MED, NCC, LCMHCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorA17391NC

General Provider Information

NPI Number : 1619652302
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA PEARL EATON MED, NCC, LCMHCA
Provider Business Mailing Address
First Line : 300 S FIRESTONE ST
Second Line : APT 339
City : GASTONIA
State : NC
Zip : 28052
Country : US
Telephone Number : 980-251-6054
Fax Number :
Provider Business Practice Location Address
First Line : 1558 UNION RD STE G
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2215
Country : US
Telephone Number : 980-251-6054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2023
Last Update Date : 06/20/2023

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Directions to “ ANNA PEARL EATON MED, NCC, LCMHCA” Practice Location

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