Provider Demographics
NPI:1558602409
Name:SPINNER, ALYSE SHARON (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:ALYSE
Middle Name:SHARON
Last Name:SPINNER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:ALYSE
Other - Middle Name:SHARON
Other - Last Name:AUERBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:107 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2337
Mailing Address - Country:US
Mailing Address - Phone:631-666-1615
Mailing Address - Fax:631-666-1709
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2337
Practice Address - Country:US
Practice Address - Phone:631-666-1615
Practice Address - Fax:631-666-1709
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR029694-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical