Provider Demographics
NPI:1114560398
Name:LOCKER, ALISON MELVILLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MELVILLE
Last Name:LOCKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2376
Mailing Address - Country:US
Mailing Address - Phone:917-533-6244
Mailing Address - Fax:
Practice Address - Street 1:375 GREENWICH ST STE 812
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2376
Practice Address - Country:US
Practice Address - Phone:917-533-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020343103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty