Provider Demographics
NPI:1619427846
Name:DENAULT, ALLYSON E (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:E
Last Name:DENAULT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-0270
Mailing Address - Country:US
Mailing Address - Phone:207-619-1419
Mailing Address - Fax:
Practice Address - Street 1:647 US ROUTE 1 STE 211B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1689
Practice Address - Country:US
Practice Address - Phone:207-619-1419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-12
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC163051041C0700X
MELC190011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical