Healthcare Provider Details

I. General information

NPI: 1538089347
Provider Name (Legal Business Name): ALICIA RENE MCNAUGHTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5013 WRIGHTSVILLE AVE
WILMINGTON NC
28403-7045
US

IV. Provider business mailing address

4813 ATLANTIS CT APT 8
WILMINGTON NC
28403-6425
US

V. Phone/Fax

Practice location:
  • Phone: 910-796-6868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024159
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: