Provider Demographics
NPI:1497182752
Name:CERVINI, ALYSSA C (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:C
Last Name:CERVINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:TUFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:145 HIGBIE LN
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3236
Mailing Address - Country:US
Mailing Address - Phone:631-572-4627
Mailing Address - Fax:
Practice Address - Street 1:145 HIGBIE LN
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795
Practice Address - Country:US
Practice Address - Phone:631-572-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0880011041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical