Provider Demographics
NPI:1750360319
Name:ALLEVIA PSYCHOLOGICAL SERVICES P.C.
Entity type:Organization
Organization Name:ALLEVIA PSYCHOLOGICAL SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:704-987-1617
Mailing Address - Street 1:709 NORTHEAST DR
Mailing Address - Street 2:SUITE 19
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7430
Mailing Address - Country:US
Mailing Address - Phone:704-987-1617
Mailing Address - Fax:704-987-0534
Practice Address - Street 1:709 NORTHEAST DR
Practice Address - Street 2:SUITE 19
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7430
Practice Address - Country:US
Practice Address - Phone:704-987-1617
Practice Address - Fax:704-987-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2596103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty