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NPI Code Detail

MEDICARE: BERNICE ALSTON LMBT

MEDICARE: BERNICE ALSTON LMBT
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
1225700000XMassage Therapist227020331IL
2225700000XMassage Therapist21687NC

General Provider Information

NPI Number : 1427912591
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNICE ALSTON LMBT
Provider Business Mailing Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 704-486-8835
Fax Number :
Provider Business Practice Location Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 704-486-8835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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