Provider Demographics
NPI:1346942448
Name:FERNANDEZ, ALISON WINTER (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:WINTER
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07704-3524
Mailing Address - Country:US
Mailing Address - Phone:848-466-0977
Mailing Address - Fax:
Practice Address - Street 1:25 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704-3524
Practice Address - Country:US
Practice Address - Phone:848-466-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC061892001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical