Provider Demographics
NPI:1598322166
Name:HENRY, ALYSON (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:
Other - Last Name:MULLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:304 E PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:304 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5369
Practice Address - Country:US
Practice Address - Phone:410-616-1834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23805104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker