Provider Demographics
NPI:1336822436
Name:LAWS, ELIJAH RASHAD (LCAS-A)
Entity Type:Individual
Prefix:
First Name:ELIJAH
Middle Name:RASHAD
Last Name:LAWS
Suffix:
Gender:M
Credentials:LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 WRENN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-7598
Mailing Address - Country:US
Mailing Address - Phone:336-470-4780
Mailing Address - Fax:
Practice Address - Street 1:8535 CLIFF CAMERON DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5909
Practice Address - Country:US
Practice Address - Phone:704-717-7477
Practice Address - Fax:704-717-7457
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29141101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)