Healthcare Provider Details

I. General information

NPI: 1164057303
Provider Name (Legal Business Name): ARLENE BLAKE GOVAN LCAS-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARLENE BLAKE GOVAN LCMHC , LCASA

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4311 SCHOOL HOUSE CMNS
HARRISBURG NC
28075-7510
US

IV. Provider business mailing address

4311 SCHOOL HOUSE CMNS
HARRISBURG NC
28075-7510
US

V. Phone/Fax

Practice location:
  • Phone: 704-453-8890
  • Fax:
Mailing address:
  • Phone: 704-453-8890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18750
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number26209
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: