MEDICARE: MR. AARON KINCAID LPCA

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	101YP2500X	Professional Counselor	A14798	NC

General Provider Information

NPI Number	:	1356907430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON KINCAID LPCA

Provider Business Mailing Address
First Line	:	808 S ZION ST
Second Line	:
City	:	LANDIS
State	:	NC
Zip	:	28088-2030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1909 J N PEASE PL STE 101
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-4509
Country	:	US
Telephone Number	:	980-313-3020
Fax Number	:

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

Provider Enumeration Date	:	05/14/2019
Last Update Date	:	05/14/2019

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