Provider Demographics
NPI:1437738614
Name:ALLISON, JEFFREY (LLMSW)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:ALLISON
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 MIDCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1138
Mailing Address - Country:US
Mailing Address - Phone:248-346-5491
Mailing Address - Fax:248-327-0333
Practice Address - Street 1:41000 WOODWARD AVE BLDG SUITE350
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5130
Practice Address - Country:US
Practice Address - Phone:248-796-2822
Practice Address - Fax:248-327-0333
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801109135101YM0800X, 106H00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist