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

Mr. Detraveus Ingram, CADC-R

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1225786296

Mr. Detraveus Ingram, CADC-R is an Addiction (Substance Use Disorder) Counselor in Pinehurst, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2022

Practice location Address checks out

20 Page Dr
Pinehurst, NC 28374-8847
Phone: (910) 235-9090
Fax: (910) 235-9093
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CADC-27212 (NC)

Record details

NPI number1225786296
Entity typeIndividual (Type 1)
GenderMale
Credentials CADC-R
Sole proprietorYes
NPI enumeratedMarch 17, 2022
Last updated in NPPESAugust 12, 2022
Certification dateMarch 17, 2022

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