Provider Demographics
NPI:1558805721
Name:MOSKAL, ALYSSA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:
Last Name:MOSKAL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LAKE ST
Mailing Address - Street 2:APT 3D
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3850
Mailing Address - Country:US
Mailing Address - Phone:315-790-1666
Mailing Address - Fax:
Practice Address - Street 1:11 LAKE ST
Practice Address - Street 2:APT 3D
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3850
Practice Address - Country:US
Practice Address - Phone:315-790-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker