Provider Demographics
NPI:1578999207
Name:HUETT, ALLYSON (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:HUETT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1230
Mailing Address - Country:US
Mailing Address - Phone:812-423-7791
Mailing Address - Fax:812-422-7558
Practice Address - Street 1:1 N BARKER AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5601
Practice Address - Country:US
Practice Address - Phone:812-423-4418
Practice Address - Fax:812-422-7558
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006873A1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN839090004OtherMEDICARE
IN000000OtherANTHEM
IN100240880Medicaid
IN154846OtherSIHO
IN12640702OtherCAQH