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General NPI Number Information
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NPI Number | 1699406371
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Entity Type | Individual
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Provider Name | KENNETH JOSEPH ENCLADE JR. LCAS
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Gender | Male
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 77 CENTRAL AVE STE A
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City | ASHEVILLE
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State | NC
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Zip | 28801-2452
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Country | US
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Telephone | 828-778-2973
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Fax | 765-392-4263
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Provider Business Mailing Address
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Address Line | 2 SPRING ST
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City | CANDLER
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State | NC
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Zip | 28715-8304
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Country | US
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Telephone | 504-432-8877
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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-28226
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License Number State | NC
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