Healthcare Provider Details

I. General information

NPI: 1417133877
Provider Name (Legal Business Name): EDWARD B KIZER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 WESTGATE RD
ASHEVILLE NC
28806-3022
US

IV. Provider business mailing address

31 WESTGATE RD
ASHEVILLE NC
28806-3022
US

V. Phone/Fax

Practice location:
  • Phone: 828-707-5376
  • Fax:
Mailing address:
  • Phone: 828-707-5376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7630
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7630
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: