Provider Demographics
NPI:1770513566
Name:CASCIANO, ALISA LOU (MED, LPC, NCC, PLLC)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:LOU
Last Name:CASCIANO
Suffix:
Gender:F
Credentials:MED, LPC, NCC, PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 WANDERVIEW LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6257
Mailing Address - Country:US
Mailing Address - Phone:919-995-4588
Mailing Address - Fax:
Practice Address - Street 1:602 EAST ACADEMY STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:FUGUAY-VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526
Practice Address - Country:US
Practice Address - Phone:919-552-9514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5079101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103035Medicaid