Provider Demographics
NPI:1114062429
Name:LA ROSA, ALLISON ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:LA ROSA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 MARCUS AVE
Mailing Address - Street 2:E110
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2000
Mailing Address - Country:US
Mailing Address - Phone:516-326-5634
Mailing Address - Fax:516-488-5934
Practice Address - Street 1:1983 MARCUS AVE
Practice Address - Street 2:E110
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2000
Practice Address - Country:US
Practice Address - Phone:516-326-5634
Practice Address - Fax:516-488-5934
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP032913-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical