Provider Demographics
NPI:1376805762
Name:ALSTON, WAYNE ALAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:ALAN
Last Name:ALSTON
Suffix:
Gender:M
Credentials:LCSW
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Mailing Address - Street 1:2230 MEADOWGLENN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8788
Mailing Address - Country:US
Mailing Address - Phone:252-258-7970
Mailing Address - Fax:252-551-5625
Practice Address - Street 1:10430 HARRIS OAK BLVD STE L
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7513
Practice Address - Country:US
Practice Address - Phone:704-360-3637
Practice Address - Fax:704-644-2513
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
NCC0118121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical