Provider Demographics
NPI:1912621814
Name:SANDERS, ALLISON (LCSWA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 TREADSTONE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-0717
Mailing Address - Country:US
Mailing Address - Phone:919-274-1185
Mailing Address - Fax:
Practice Address - Street 1:203 N MAIN ST STE 314
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5343
Practice Address - Country:US
Practice Address - Phone:336-647-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0180681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical