Provider Demographics
NPI:1922485291
Name:GURAL, JENNIFER (LCASA 20323)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GURAL
Suffix:
Gender:F
Credentials:LCASA 20323
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3365
Mailing Address - Country:US
Mailing Address - Phone:662-648-0249
Mailing Address - Fax:828-350-1300
Practice Address - Street 1:119 TUNNEL RD
Practice Address - Street 2:SUITE D
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1869
Practice Address - Country:US
Practice Address - Phone:828-350-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS 20323101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)