Provider Demographics
NPI:1447143730
Name:EKKENS, CONRAD
Entity type:Individual
Prefix:
First Name:CONRAD
Middle Name:
Last Name:EKKENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NEWBRIDGE PKWY UNIT 107
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1489
Mailing Address - Country:US
Mailing Address - Phone:828-407-8319
Mailing Address - Fax:
Practice Address - Street 1:901 OLD MARS HILL HWY STE 3
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-8628
Practice Address - Country:US
Practice Address - Phone:864-360-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor