Provider Demographics
NPI:1730721580
Name:MCLAURIN, ALLISON WHALEY (MED, NCC, LPCA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:WHALEY
Last Name:MCLAURIN
Suffix:
Gender:F
Credentials:MED, NCC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9915 PIN OAK ACRES WAY UNIT 315
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0468
Mailing Address - Country:US
Mailing Address - Phone:803-984-9843
Mailing Address - Fax:
Practice Address - Street 1:104 WAXHAW PROFESSIONAL PARK DR STE D
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-5020
Practice Address - Country:US
Practice Address - Phone:980-209-2296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15168101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health