=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619760881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLISON EDDY, LCSW, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2025
-----------------------------------------------------
Last Update Date | 05/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18 HILLSIDE ST
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28787-9206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-942-0222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18 HILLSIDE ST
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28787-9206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-942-0222
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORGANIZER/OWNER; MSW/LCSW
-----------------------------------------------------
Name | ALLISON EDDY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-942-0222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------