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General NPI Number Information
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NPI Number | 1235802554
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Entity Type | Individual
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Provider Name | JESSICA NICOLE MCALLISTER LCSWA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 806 HAY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5312
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Country | US
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Telephone | 910-860-7008
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Fax | 910-824-7593
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Provider Business Mailing Address
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Address Line | 2919 BREEZEWOOD AVE STE 101
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5283
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Country | US
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Telephone | 910-484-1711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P020999
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 11952
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License Number State | NC
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