MEDICARE: ALLISON SUSTAR LCMHCA

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
1	101YM0800X	Mental Health Counselor	A22449	NC

General Provider Information

NPI Number	:	1437018009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON SUSTAR LCMHCA

Provider Business Mailing Address
First Line	:	3036 CHENANGO DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-6675
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3013 SENNA DR STE A
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-6727
Country	:	US
Telephone Number	:	980-533-5649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ ALLISON SUSTAR LCMHCA” Practice Location

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