Provider Demographics
NPI:1568837037
Name:VINYARD, ALLISON (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:VINYARD
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 1:449 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3241
Mailing Address - Country:US
Mailing Address - Phone:248-890-5878
Mailing Address - Fax:
Practice Address - Street 1:449 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3241
Practice Address - Country:US
Practice Address - Phone:248-890-5878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010920121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical