Provider Demographics
NPI:1003014580
Name:ALLER, CAROLINE (LICSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:ALLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 S PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3802
Mailing Address - Country:US
Mailing Address - Phone:413-835-1558
Mailing Address - Fax:866-240-7441
Practice Address - Street 1:24 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3802
Practice Address - Country:US
Practice Address - Phone:413-835-1558
Practice Address - Fax:866-240-7441
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
MA1162091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist