Provider Demographics
NPI:1336334713
Name:MEYER, KAMBRA J (LCMHC/LCAS)
Entity type:Individual
Prefix:
First Name:KAMBRA
Middle Name:J
Last Name:MEYER
Suffix:
Gender:F
Credentials:LCMHC/LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 MERRIMON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1223
Mailing Address - Country:US
Mailing Address - Phone:828-367-7077
Mailing Address - Fax:
Practice Address - Street 1:383 MERRIMON AVE STE C
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1223
Practice Address - Country:US
Practice Address - Phone:828-367-7077
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2048101YA0400X
NC6721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103708Medicaid