MEDICARE: ASHLEY LAVETTE HOOVER MS, LPC, LCAS-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-28649	NC

General Provider Information

NPI Number	:	1245761535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LAVETTE HOOVER MS, LPC, LCAS-A

Provider Business Mailing Address
First Line	:	9121 TROON LN UNIT B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-2192
Country	:	US
Telephone Number	:	608-346-9942
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 BACK CREEK DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-2159
Country	:	US
Telephone Number	:	608-346-9942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2017
Last Update Date	:	06/04/2024

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