Provider Demographics
NPI:1659091080
Name:ALSTON, ALYSSIA SYMONE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSSIA
Middle Name:SYMONE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:23075-0037
Mailing Address - Country:US
Mailing Address - Phone:804-837-9745
Mailing Address - Fax:
Practice Address - Street 1:653 LENTEN ROSE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5862
Practice Address - Country:US
Practice Address - Phone:804-837-9745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040142321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical