MEDICARE: MR. LAVERNE BRUCE LCAS-P

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		NC

General Provider Information

NPI Number	:	1750653945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAVERNE BRUCE LCAS-P

Provider Business Mailing Address
First Line	:	504 E ELIZABETH ST STE 1
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-4472
Country	:	US
Telephone Number	:	252-619-0319
Fax Number	:

Provider Business Practice Location Address
First Line	:	504 E ELIZABETH ST STE 1
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-4472
Country	:	US
Telephone Number	:	252-619-0319
Fax Number	:

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

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

Similar Medicare Providers

1538124094 — CAROLINA PLASTIC SURGERY SPECIALISTS INC
Practice Location Address:

504 E ELIZABETH ST , STE 4
ELIZABETH CITY, NC
27909-4472

Practice Phone: 252-384-0919
Practice Fax: 252-384-0916

1376855023 — WOMEN FIRST OB GYN PLLC
Practice Location Address:

1177 NORTH ROAD STREET
ELIZABETH CITY, NC
27909-4472

Practice Phone: 252-338-9080
Practice Fax: 252-338-6712

1891755104 — MRS. KIMBERLY L VERELLEN PA-C
Practice Location Address:

4472 MAIN ST
BROWN CITY, MI
48416-7908

Practice Phone: 810-346-2751
Practice Fax: 810-346-3238

1376695205 — MARLETTE REGIONAL HOSPITAL
Practice Location Address:

4472 MAIN ST
BROWN CITY, MI
48416-7908

Practice Phone: 810-346-2751
Practice Fax: 810-346-3238

1669515342 — TALLAPOOSA COUNTY HEALTH DEPT-ALEX CITY EPSDT CM
Practice Location Address:

2078 SPORTPLEX BLVD
ALEXANDER CITY, AL
35010-4472

Practice Phone: 256-329-0531
Practice Fax:

1356484653 — TALLAPOOSA COUNTY HEALTH DEPT-ALEX CITY AIDS
Practice Location Address:

2078 SPORTPLEX BLVD
ALEXANDER CITY, AL
35010-4472

Practice Phone: 256-329-0531
Practice Fax:

Directions to “ MR. LAVERNE BRUCE LCAS-P” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.