Provider Demographics
NPI:1508462912
Name:ARAUCO, ALYSIA (LMSW)
Entity Type:Individual
Prefix:
First Name:ALYSIA
Middle Name:
Last Name:ARAUCO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-4828
Mailing Address - Country:US
Mailing Address - Phone:254-415-5570
Mailing Address - Fax:
Practice Address - Street 1:915 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-4828
Practice Address - Country:US
Practice Address - Phone:254-415-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64516104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker