Provider Demographics
NPI:1376090902
Name:WOODFIELD, ALLISON NICOLE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:NICOLE
Last Name:WOODFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21500 HAGGERTY RD STE 350
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-8992
Mailing Address - Country:US
Mailing Address - Phone:862-435-9675
Mailing Address - Fax:
Practice Address - Street 1:21500 HAGGERTY RD STE 350
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-8992
Practice Address - Country:US
Practice Address - Phone:862-435-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1462371Medicaid