Healthcare Provider Details

I. General information

NPI: 1508899097
Provider Name (Legal Business Name): DAMALI ALSTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S ESTES DR SUITE 301-V
CHAPEL HILL NC
27514-2866
US

IV. Provider business mailing address

108 VINTAGE DR
CHAPEL HILL NC
27516-9411
US

V. Phone/Fax

Practice location:
  • Phone: 919-593-4037
  • Fax:
Mailing address:
  • Phone: 919-593-4037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC001594
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: