Individual
KEVIN THOMAS EGROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDAC
Contact information
Practice address
2134 AUGUSTA ST, CHARLOTTE, NC 28216-4603
(980) 240-4352
Mailing address
2134 AUGUSTA ST, CHARLOTTE, NC 28216-4603
(980) 240-4352
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85-1217548
BCBS NC
NC
05
—
85-1217548
—
NC
Enumeration date
05/29/2020
Last updated
05/29/2020
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