Provider Demographics
NPI:1144458985
Name:SUGAR, ALYSSA ANN (CRC, PLCAS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ANN
Last Name:SUGAR
Suffix:
Gender:F
Credentials:CRC, PLCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600A COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6386
Mailing Address - Country:US
Mailing Address - Phone:252-439-1011
Mailing Address - Fax:252-439-1013
Practice Address - Street 1:600A COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6386
Practice Address - Country:US
Practice Address - Phone:252-439-1011
Practice Address - Fax:252-439-1013
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00107063101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor