Provider Demographics
NPI:1558710509
Name:CARR, ALISON (LICSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:MAZZONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 CANDICE COURT
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:617-340-9667
Mailing Address - Fax:
Practice Address - Street 1:623 MAIN ST
Practice Address - Street 2:SUITE 25
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:617-340-9667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA221195104100000X
MA1209161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker