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NPI 1023667748

NPI 1023667748 : RENEE MINX LCAS-A, LCSW-A : ASHEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1023667748
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    Entity Type          |    Individual 
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    Provider Name        |    RENEE MINX LCAS-A, LCSW-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/05/2019
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    Last Update Date     |    09/05/2019
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Provider Practice Location Address
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    Address Line         |    191 CHARLOTTE ST 
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    City                 |    ASHEVILLE
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    State                |    NC
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    Zip                  |    28801-1989
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    Country              |    US
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    Telephone            |    828-348-7394
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    191 CHARLOTTE ST 
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    City                 |    ASHEVILLE
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    State                |    NC
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    Zip                  |    28801-1989
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    Country              |    US
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    Telephone            |    828-348-7394
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    LCAS-25629
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    P013409
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    License Number State |    NC
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