Provider Demographics
NPI:1508205832
Name:CHAN, ALLISON SPANGLER (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:SPANGLER
Last Name:CHAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12893 CLARKSBURG SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4342
Mailing Address - Country:US
Mailing Address - Phone:336-655-3555
Mailing Address - Fax:
Practice Address - Street 1:1438 RHODE ISLAND AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-3709
Practice Address - Country:US
Practice Address - Phone:202-543-3217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD165311041C0700X
DCLC500796521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical