Basic Information
Provider Information
NPI: 1043581069
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLISON
FirstName: MARJORIE
MiddleName: LUNNEN
NamePrefix:  
NameSuffix:  
Credential: LCSW, LCAS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 119 TUNNEL RD
Address2: SUITE D
City: ASHEVILLE
State: NC
PostalCode: 288051869
CountryCode: US
TelephoneNumber: 8283501000
FaxNumber: 8283501300
Practice Location
Address1: 1 OAK PLZ
Address2: SUITE 206
City: ASHEVILLE
State: NC
PostalCode: 288013008
CountryCode: US
TelephoneNumber: 8282522501
FaxNumber: 8282522701
Other Information
ProviderEnumerationDate: 01/23/2012
LastUpdateDate: 02/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XC008761NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical
101YA0400X2663NCN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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