Individual
MR. TONY RAY BEATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS, CCS
Contact information
Practice address
429 BILLINGSLEY RD, CHARLOTTE, NC 28211-1007
(704) 336-3067
(704) 353-0390
Mailing address
3430 WHEATLEY AVE, CHARLOTTE, NC 28205-7654
(704) 336-5622
(704) 353-0390
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
318
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6110539
—
NC
Enumeration date
09/28/2006
Last updated
07/09/2007
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