Provider Demographics
NPI:1487215190
Name:VERSTRAETE, ALLISON ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:VERSTRAETE
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 1:3671 SOUTHWESTERN BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1749
Mailing Address - Country:US
Mailing Address - Phone:716-895-7207
Mailing Address - Fax:
Practice Address - Street 1:3671 SOUTHWESTERN BLVD STE 209
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1749
Practice Address - Country:US
Practice Address - Phone:716-895-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical