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NPI Code Detail

MEDICARE: DARRYL X MCALLISTER PHD, LCSW

MEDICARE: DARRYL X MCALLISTER PHD, LCSW
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 WorkerC00269NC
2101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-1610NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
155400OTHERNCBCBS NC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720277767
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRYL X MCALLISTER PHD, LCSW
Provider Business Mailing Address
First Line : PO BOX 1004
Second Line :
City : LUMBERTON
State : NC
Zip : 28359-1004
Country : US
Telephone Number : 910-738-1587
Fax Number : 910-738-1581
Provider Business Practice Location Address
First Line : 3581 LACKEY ST
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-9048
Country : US
Telephone Number : 910-738-1587
Fax Number : 910-738-1581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2007
Last Update Date : 06/23/2021

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