Provider Demographics
NPI:1053833533
Name:VERLEE, ALLISON FAERYN (LICSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FAERYN
Last Name:VERLEE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NICOLE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:25 ANDREW ST.
Mailing Address - Street 2:UNIT 3
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:857-337-9247
Mailing Address - Fax:978-224-5877
Practice Address - Street 1:25 ANDREW ST
Practice Address - Street 2:UNIT 3
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-924-4209
Practice Address - Fax:978-224-5877
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MA124091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical