Provider Demographics
NPI:1427541275
Name:ALLESHOUSE, JOANN S (LMSW)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:S
Last Name:ALLESHOUSE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 N 900 E
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:IN
Mailing Address - Zip Code:46746-9594
Mailing Address - Country:US
Mailing Address - Phone:269-503-3537
Mailing Address - Fax:
Practice Address - Street 1:6255 N 900 E
Practice Address - Street 2:
Practice Address - City:HOWE
Practice Address - State:IN
Practice Address - Zip Code:46746
Practice Address - Country:US
Practice Address - Phone:269-503-3537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010708141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical