MEDICARE: ALESSANDRA MARIACHIARA NELSON LCMHC

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	101YM0800X	Mental Health Counselor	4361	NC

General Provider Information

NPI Number	:	1649259573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALESSANDRA MARIACHIARA NELSON LCMHC

Provider Business Mailing Address
First Line	:	PO BOX 87501
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-7501
Country	:	US
Telephone Number	:	910-286-2820
Fax Number	:	910-676-7332

Provider Business Practice Location Address
First Line	:	5135 MORGANTON RD STE 109
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1525
Country	:	US
Telephone Number	:	910-286-2820
Fax Number	:	910-676-7332

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	04/12/2024

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