Provider Demographics
NPI:1134692437
Name:WALDRON, ALYSON L (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:L
Last Name:WALDRON
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 1:300 NORTH AVE E
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2435
Mailing Address - Country:US
Mailing Address - Phone:908-276-2244
Mailing Address - Fax:908-931-0304
Practice Address - Street 1:300 NORTH AVE E
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2435
Practice Address - Country:US
Practice Address - Phone:908-276-2244
Practice Address - Fax:908-931-0304
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058111001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical