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NPI Code Detail

MEDICARE: ASIYAH ALSTON

MEDICARE:   ASIYAH  ALSTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker118278TX
21041C0700XClinical Social WorkerSW21954FL

General Provider Information

NPI Number : 1154805901
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASIYAH ALSTON
Provider Business Mailing Address
First Line : 111 S BEDFORD ST STE 205
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-5145
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4320 S HOPKINS AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-6610
Country : US
Telephone Number : 603-518-6725
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2018
Last Update Date : 01/30/2026

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