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Individual

DENTAVIUS LAMARN BARBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, LCASA

Contact information

Practice address
5855 EXECUTIVE CENTER DR, SUITE 111, CHARLOTTE, NC 28212-8883
(704) 537-1202
Mailing address
2071 MALLARD CREEK DR, ROCK HILL, SC 29732-7549
(803) 487-8676

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2396-A
NC
101YM0800X
Mental Health Counselor
Primary
8231
NC
101YP2500X
Professional Counselor
8231
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6115040
NC
Enumeration date
10/15/2010
Last updated
03/03/2013
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