Basic Information
| Provider Information | |||||||||
| NPI: | 1568130110 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVES | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | VIOLETTE | ||||||||
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| Credential: | CDAC-R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 LEES CREEK RD UNIT D | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288065104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285053086 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6 ROBERTS RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288036631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285053086 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2021 | ||||||||
| LastUpdateDate: | 08/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 26748 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.