Provider Demographics
NPI:1295016160
Name:NEWMAN, ALISON BROWN (LICSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BROWN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WALTHAM ST STE 10
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5409
Mailing Address - Country:US
Mailing Address - Phone:617-651-1988
Mailing Address - Fax:
Practice Address - Street 1:114 WALTHAM ST STE 10
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5409
Practice Address - Country:US
Practice Address - Phone:617-651-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1177791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1200607Medicaid