Provider Demographics
NPI:1417622622
Name:PETERS, ALYSSA (MSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 S PLEASANT AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2196
Mailing Address - Country:US
Mailing Address - Phone:814-443-1754
Mailing Address - Fax:814-443-1895
Practice Address - Street 1:223 S PLEASANT AVE STE 104
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2196
Practice Address - Country:US
Practice Address - Phone:814-443-1754
Practice Address - Fax:814-443-1895
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)