Provider Demographics
NPI:1245400027
Name:ALIG, ALAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:ALIG
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 142682
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214
Mailing Address - Country:US
Mailing Address - Phone:770-990-9871
Mailing Address - Fax:770-716-0501
Practice Address - Street 1:275 COUNTRY CLUB DRIVE
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281
Practice Address - Country:US
Practice Address - Phone:770-474-8400
Practice Address - Fax:770-474-3738
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
GANA101YP2500X
GA5579101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health