Provider Demographics
NPI:1003189788
Name:BASSETT, ALLISON (MSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HOWE ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4620
Mailing Address - Country:US
Mailing Address - Phone:203-946-3081
Mailing Address - Fax:203-946-3085
Practice Address - Street 1:205 ORANGE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2069
Practice Address - Country:US
Practice Address - Phone:203-776-9900
Practice Address - Fax:203-397-9077
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT454104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program