Provider Demographics
NPI:1518716729
Name:EASON, KEVIN B (MA, LCMHCA, NCC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:B
Last Name:EASON
Suffix:
Gender:M
Credentials:MA, LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7283 VETERANS PKWY STE 102-182
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-7529
Mailing Address - Country:US
Mailing Address - Phone:984-334-2867
Mailing Address - Fax:919-551-7541
Practice Address - Street 1:4909 WATERS EDGE DR STE 101D
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2462
Practice Address - Country:US
Practice Address - Phone:984-334-2867
Practice Address - Fax:919-551-7541
Is Sole Proprietor?:No
Enumeration Date:2024-05-18
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCA20005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health