Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Lee Beaver, MA, LCAS-A

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1003689563

Ethan Lee Beaver, MA, LCAS-A is an Addiction (Substance Use Disorder) Counselor in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2023.

Licensed in
NC
In the registry since
2023
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

616 Colonnade Dr
Charlotte, NC 28205-6827
Phone: (704) 273-3942
Fax: (704) 749-2305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LCAS-29534 (NC)

Record details

NPI number1003689563
Entity typeIndividual (Type 1)
GenderMale
Credentials MA , LCAS-A
Sole proprietorNo
NPI enumeratedNovember 6, 2023
Last updated in NPPESNovember 6, 2023
Certification dateNovember 6, 2023

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