Provider Demographics
NPI:1497121891
Name:DEEHAN, ALLISON LEWIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:LEWIN
Last Name:DEEHAN
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 1:1201 KINGS HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5319
Mailing Address - Country:US
Mailing Address - Phone:240-401-6215
Mailing Address - Fax:
Practice Address - Street 1:430 MILL HILL TER
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1232
Practice Address - Country:US
Practice Address - Phone:240-401-6215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095068104100000X
CT0114121041C0700X
NY0880521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker