Basic Information
Provider Information
NPI: 1003142076
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZAMBRANO
FirstName: ALANNA
MiddleName: ALEXANDER
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ALEXANDER
OtherFirstName: ALANNA
OtherMiddleName: FAE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 601 N. CHERRY ST.
Address2: SUITE 300
City: WINSTON-SALEM
State: NC
PostalCode: 271012933
CountryCode: US
TelephoneNumber: 3367484007
FaxNumber: 3367484108
Practice Location
Address1: 601 N. CHERRY ST.
Address2: SUITE 300
City: WINSTON-SALEM
State: NC
PostalCode: 271012933
CountryCode: US
TelephoneNumber: 3367484007
FaxNumber: 3367484108
Other Information
ProviderEnumerationDate: 10/27/2009
LastUpdateDate: 10/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500X  N Behavioral Health & Social Service ProvidersCounselorProfessional
101YS0200X  N Behavioral Health & Social Service ProvidersCounselorSchool
1041C0700X  Y Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041S0200X  N Behavioral Health & Social Service ProvidersSocial WorkerSchool

No ID Information.


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