MEDICARE: MR. CHRISTOPHER JAMES MACEMORE M.S, 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-23958	NC

General Provider Information

NPI Number	:	1659778199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER JAMES MACEMORE M.S, LCAS-A

Provider Business Mailing Address
First Line	:	275 DARNELL AVE
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-8853
Country	:	US
Telephone Number	:	336-244-3328
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 DARNELL AVE
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-8853
Country	:	US
Telephone Number	:	336-244-3328
Fax Number	:

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

Provider Enumeration Date	:	11/27/2014
Last Update Date	:	04/18/2026

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