Provider Demographics
NPI:1487033528
Name:ALISON LEWIS, LCSW, LLC
Entity Type:Organization
Organization Name:ALISON LEWIS, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:KS
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-490-5157
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06232-0023
Mailing Address - Country:US
Mailing Address - Phone:860-490-5157
Mailing Address - Fax:860-498-1237
Practice Address - Street 1:357 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4472
Practice Address - Country:US
Practice Address - Phone:860-490-5157
Practice Address - Fax:860-498-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0089061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty