Provider Demographics
NPI:1518436237
Name:OUIMET, ALLAN JOSEPH (LICSW-MA, LCSW-CT)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:JOSEPH
Last Name:OUIMET
Suffix:
Gender:M
Credentials:LICSW-MA, LCSW-CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 1/2 RUSSELL ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-2162
Mailing Address - Country:US
Mailing Address - Phone:413-539-0964
Mailing Address - Fax:
Practice Address - Street 1:16 1/2 RUSSELL ROAD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-2162
Practice Address - Country:US
Practice Address - Phone:413-539-0964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0081381041C0700X
MA1177773-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical