Provider Demographics
NPI:1508030305
Name:ALSTON, PATRICIA CHRISTINE (LCAS 21563)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:CHRISTINE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:LCAS 21563
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:CHRISTINE
Other - Last Name:ALSTON-DAYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAS 21563
Mailing Address - Street 1:5110 NEUSE COMMONS LN
Mailing Address - Street 2:SUITE106
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8376
Mailing Address - Country:US
Mailing Address - Phone:919-426-9463
Mailing Address - Fax:
Practice Address - Street 1:833 WAKE FOREST BUSINESS PARK
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6523
Practice Address - Country:US
Practice Address - Phone:919-426-9463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21536101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)