Provider Demographics
NPI:1972631794
Name:ALSTON, BRIAN C (MA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:C
Last Name:ALSTON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3170
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-6170
Mailing Address - Country:US
Mailing Address - Phone:808-217-1831
Mailing Address - Fax:
Practice Address - Street 1:3-3122 KUHIO HWY
Practice Address - Street 2:A15
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1147
Practice Address - Country:US
Practice Address - Phone:808-246-9102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health