Provider Demographics
NPI:1740655695
Name:HOWARD, NANNETTE MUNN (LCAS-A)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:MUNN
Last Name:HOWARD
Suffix:
Gender:F
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 1:400 BEVERLY HANKS CTR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2303
Mailing Address - Country:US
Mailing Address - Phone:828-595-9558
Mailing Address - Fax:828-595-9598
Practice Address - Street 1:400 BEVERLY HANKS CTR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2303
Practice Address - Country:US
Practice Address - Phone:828-595-9558
Practice Address - Fax:828-595-9598
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21267101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1740655695Medicaid