Provider Demographics
NPI:1316004203
Name:TESTA, ALISA (LICSW)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:TESTA
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 1:15 MONUMENT SQ STE 200
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-5711
Mailing Address - Country:US
Mailing Address - Phone:774-437-2692
Mailing Address - Fax:978-534-8723
Practice Address - Street 1:15 MONUMENT SQ STE 200
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-5711
Practice Address - Country:US
Practice Address - Phone:774-437-2692
Practice Address - Fax:978-534-8723
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1178451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical