1083392617 NPI number — ALLYSON HUNTER STUMBAUGH LCSW-A, LCAS-A

NPI Number: 1083392617
Health Care Provider/Practitioner: ALLYSON HUNTER STUMBAUGH LCSW-A, LCAS-A

NPI Number : 1083392617 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083392617",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STUMBAUGH",
    "FirstName": "ALLYSON",
    "MiddleName": "HUNTER",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW-A, LCAS-A",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "312 BECK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GOLDSBORO",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "27534-5430",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-567-3951",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "510 CHURCH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BLACK CREEK",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "27813-9022",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "252-281-1718",
    "PracticeLocationAddressFaxNumber": "252-281-4842",
    "EnumerationDate": "07/05/2023",
    "LastUpdateDate": "10/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "LCAS-29079",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "C019122",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}