Provider Demographics
NPI:1871349738
Name:ALSTON, STEPHON (BSW)
Entity type:Individual
Prefix:
First Name:STEPHON
Middle Name:
Last Name:ALSTON
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 CALESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BONNEAU
Mailing Address - State:SC
Mailing Address - Zip Code:29431-3246
Mailing Address - Country:US
Mailing Address - Phone:843-291-4959
Mailing Address - Fax:
Practice Address - Street 1:2470 MALL DR STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6514
Practice Address - Country:US
Practice Address - Phone:800-805-6989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty