Provider Demographics
NPI:1144666876
Name:MCALLISTER, YOLANDA (LCASA)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1343
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302-1343
Mailing Address - Country:US
Mailing Address - Phone:910-738-1587
Mailing Address - Fax:910-739-6698
Practice Address - Street 1:3581 LACKEY ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-9048
Practice Address - Country:US
Practice Address - Phone:910-738-1587
Practice Address - Fax:910-739-6699
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3257A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3257AOtherPROVISIONAL