Provider Demographics
NPI:1588174049
Name:REMINGTON, ANN LORETTA (LCAS)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LORETTA
Last Name:REMINGTON
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 7 LKS N
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9760
Mailing Address - Country:US
Mailing Address - Phone:910-528-2697
Mailing Address - Fax:
Practice Address - Street 1:20 PAGE DR STE 7&8
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8847
Practice Address - Country:US
Practice Address - Phone:910-235-9090
Practice Address - Fax:910-235-9093
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22938101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty