Provider Demographics
NPI:1568137131
Name:ALISON MCKENSIE PLLC
Entity Type:Organization
Organization Name:ALISON MCKENSIE PLLC
Other - Org Name:SOUTHEASTERN BEHAVIORAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:MCKENSIE
Authorized Official - Last Name:ELLING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:980-443-7328
Mailing Address - Street 1:1850 E 3RD ST STE 120
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3234
Mailing Address - Country:US
Mailing Address - Phone:980-443-7328
Mailing Address - Fax:
Practice Address - Street 1:1850 E 3RD ST STE 120
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3234
Practice Address - Country:US
Practice Address - Phone:980-443-7328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-14
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty