Healthcare Provider Details

I. General information

NPI: 1073446126
Provider Name (Legal Business Name): AILENE VAYAS LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6253 ACACIA PL
MIDLAND NC
28107-6707
US

IV. Provider business mailing address

6253 ACACIA PL
MIDLAND NC
28107-6707
US

V. Phone/Fax

Practice location:
  • Phone: 980-829-8393
  • Fax:
Mailing address:
  • Phone: 980-829-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21915
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: