Provider Demographics
NPI:1295954204
Name:ALSTON, PAUL PERRY I (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:PERRY
Last Name:ALSTON
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8947
Mailing Address - Country:US
Mailing Address - Phone:252-756-1702
Mailing Address - Fax:
Practice Address - Street 1:219 CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-8947
Practice Address - Country:US
Practice Address - Phone:252-756-1702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0360103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling