Individual
ALIA ZYATTA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
242 MIDDLE ST, NEW BERN, NC 28560-2142
(252) 631-6260
Mailing address
409 FISHING CREEK DR, NEW BERN, NC 28562-8394
(252) 631-6260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-23708
NC
101YM0800X
Mental Health Counselor
P011460
NC
1041C0700X
Clinical Social Worker
Primary
C012806
NC
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
01/06/2012
Last updated
01/26/2021
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