Provider Demographics
NPI:1457498891
Name:GENTILLE, ALLISON DAWN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:DAWN
Last Name:GENTILLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19420 GOLF VISTA PLZ STE 350
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8268
Mailing Address - Country:US
Mailing Address - Phone:703-869-4633
Mailing Address - Fax:
Practice Address - Street 1:19420 GOLF VISTA PLZ STE 350
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8268
Practice Address - Country:US
Practice Address - Phone:703-869-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040058961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical