Healthcare Provider Details

I. General information

NPI: 1295151108
Provider Name (Legal Business Name): DONA MENZ LPC, LCAS, NCC, REV.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2014
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 CHARLOTTE ST
ASHEVILLE NC
28801-1908
US

IV. Provider business mailing address

1193 BRIGHTWATER DR
HENDERSONVILLE NC
28739-8151
US

V. Phone/Fax

Practice location:
  • Phone: 828-808-1989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS 2818
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberNCC 285629
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC 8935
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberADL CHAPEL 1925
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: