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NPI 1740178656

NPI 1740178656 : DEBRA ELAINE ALSTON SUPERVISEE IN SW : NORFOLK, VA

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General NPI Number Information
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    NPI Number           |    1740178656
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    Entity Type          |    Individual 
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    Provider Name        |    DEBRA ELAINE ALSTON SUPERVISEE IN SW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/27/2025
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    Last Update Date     |    06/27/2025
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Provider Practice Location Address
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    Address Line         |    1761 CHURCH ST UNIT 109 
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    City                 |    NORFOLK
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    State                |    VA
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    Zip                  |    23504-2313
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    Country              |    US
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    Telephone            |    757-440-3125
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    Fax                  |    757-481-8259
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Provider Business Mailing Address
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    Address Line         |    1761 CHURCH ST UNIT 109 
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    City                 |    NORFOLK
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    State                |    VA
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    Zip                  |    23504-2313
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    Country              |    US
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    Telephone            |    757-440-3125
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    Fax                  |    757-481-8259
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    0906015313
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    License Number State |    VA
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