Provider Demographics
NPI:1104405224
Name:MCGLONE, ALYSIA WILLIAMS
Entity type:Individual
Prefix:
First Name:ALYSIA
Middle Name:WILLIAMS
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSIA
Other - Middle Name:NICOLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:137 BUCKHILL VILLAGE DR APT 206
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8258
Mailing Address - Country:US
Mailing Address - Phone:336-446-9746
Mailing Address - Fax:
Practice Address - Street 1:137 BUCKHILL VILLAGE DR APT 206
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8258
Practice Address - Country:US
Practice Address - Phone:336-446-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15930101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor