Provider Demographics
NPI:1568520799
Name:BOONE, ALYSON ALMOND (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:ALMOND
Last Name:BOONE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 POPLAR GROVE TRL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8629
Mailing Address - Country:US
Mailing Address - Phone:336-664-5791
Mailing Address - Fax:
Practice Address - Street 1:6700 POPLAR GROVE TRL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8629
Practice Address - Country:US
Practice Address - Phone:336-664-5791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6105097Medicaid