Provider Demographics
NPI:1619166089
Name:CARROLL, ALISON A (LCSWR)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:A
Last Name:CARROLL
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 WHITE PLAINS RD STE 510
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5152
Mailing Address - Country:US
Mailing Address - Phone:914-345-5900
Mailing Address - Fax:
Practice Address - Street 1:1808 ROUTE 6
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2356
Practice Address - Country:US
Practice Address - Phone:845-225-2700
Practice Address - Fax:845-225-3207
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0334591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNH9981Medicare PIN