Provider Demographics
NPI:1922527910
Name:ALEXANDER AVERY, BILLIE ANNE (LCAS)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:ANNE
Last Name:ALEXANDER AVERY
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 HAYES WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-8749
Mailing Address - Country:US
Mailing Address - Phone:847-848-6308
Mailing Address - Fax:
Practice Address - Street 1:3209 GRESHAM LAKE RD STE 113
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4131
Practice Address - Country:US
Practice Address - Phone:919-977-5993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23842101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)