Provider Demographics
NPI:1922364546
Name:ALSTON, AISHA (MA LPCA)
Entity Type:Individual
Prefix:MISS
First Name:AISHA
Middle Name:
Last Name:ALSTON
Suffix:
Gender:F
Credentials:MA LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 FOREST MILL CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8406
Mailing Address - Country:US
Mailing Address - Phone:919-247-9324
Mailing Address - Fax:
Practice Address - Street 1:1517 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-8579
Practice Address - Country:US
Practice Address - Phone:919-247-9324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8776101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10152OtherLPC LICENSE NUMBER