Provider Demographics
NPI:1821160433
Name:AYRE, JUSTIN ALDEN (LCSW, CAS-I)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:ALDEN
Last Name:AYRE
Suffix:
Gender:M
Credentials:LCSW, CAS-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3125 POPLARWOOD CT
Mailing Address - Street 2:#203
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-6445
Mailing Address - Country:US
Mailing Address - Phone:919-787-6131
Mailing Address - Fax:919-571-2832
Practice Address - Street 1:301 SUNSET DRIVE
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2196
Practice Address - Country:US
Practice Address - Phone:919-787-6131
Practice Address - Fax:919-787-6131
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0046611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical