Provider Demographics
NPI:1114513181
Name:ALLSHOUSE, NANCY L (LMHC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:ALLSHOUSE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-1535
Mailing Address - Country:US
Mailing Address - Phone:716-720-1274
Mailing Address - Fax:
Practice Address - Street 1:200 E TERRACE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NY
Practice Address - Zip Code:14750-1535
Practice Address - Country:US
Practice Address - Phone:716-720-1274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010619-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health