Provider Demographics
NPI:1770218349
Name:ALLEN, PHYLICIA (LCSWA)
Entity Type:Individual
Prefix:
First Name:PHYLICIA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12339 WAKE UNION CHURCH RD STE 111
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4512
Mailing Address - Country:US
Mailing Address - Phone:919-867-0360
Mailing Address - Fax:
Practice Address - Street 1:12339 WAKE UNION CHURCH RD STE 111
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4512
Practice Address - Country:US
Practice Address - Phone:919-867-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical