Provider Demographics
NPI:1457528754
Name:ALLEN, BRIAN CLAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:CLAY
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 W CONE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4318
Mailing Address - Country:US
Mailing Address - Phone:336-288-2323
Mailing Address - Fax:336-288-0895
Practice Address - Street 1:1510 W CONE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4318
Practice Address - Country:US
Practice Address - Phone:336-288-2323
Practice Address - Fax:336-288-0895
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional