Provider Demographics
NPI:1013387117
Name:KRZANOWSKI, ALLISON (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KRZANOWSKI
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-7144
Mailing Address - Country:US
Mailing Address - Phone:207-945-4240
Mailing Address - Fax:
Practice Address - Street 1:13 PARK ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2623
Practice Address - Country:US
Practice Address - Phone:603-969-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-01
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC156561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical