Provider Demographics
NPI:1801767314
Name:JAMES, AVIYANNA LASHELLE
Entity type:Individual
Prefix:
First Name:AVIYANNA
Middle Name:LASHELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 DORADO CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-0638
Mailing Address - Country:US
Mailing Address - Phone:984-444-0824
Mailing Address - Fax:
Practice Address - Street 1:6985 NEXUS CT STE 107
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3186
Practice Address - Country:US
Practice Address - Phone:910-493-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty