MEDICARE: MRS. ALENA SERYODKIN ABAT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	20489	NC

General Provider Information

NPI Number	:	1518895705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALENA SERYODKIN ABAT

Provider Business Mailing Address
First Line	:	539 SUMMERLEA DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1131
Country	:	US
Telephone Number	:	916-475-8281
Fax Number	:

Provider Business Practice Location Address
First Line	:	5135 MORGANTON RD STE 101
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1525
Country	:	US
Telephone Number	:	910-551-1670
Fax Number	:	910-491-0335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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