Provider Demographics
NPI:1316224470
Name:SPANN, DAVID (LCAS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPANN
Suffix:
Gender:M
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3146
Mailing Address - Country:US
Mailing Address - Phone:828-337-2586
Mailing Address - Fax:
Practice Address - Street 1:1200 RIDGEFIELD BLVD STE 261
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2288
Practice Address - Country:US
Practice Address - Phone:828-337-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1843101YA0400X
NCP0061831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)