Provider Demographics
NPI:1831680289
Name:ALLISON, BRANDON LEE (LCMHC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:LEE
Last Name:ALLISON
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 GILEAD RD STE H
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6814
Mailing Address - Country:US
Mailing Address - Phone:828-350-1177
Mailing Address - Fax:
Practice Address - Street 1:403 GILEAD RD STE H
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6814
Practice Address - Country:US
Practice Address - Phone:828-350-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13046101YP2500X
NCA13046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional