Provider Demographics
NPI:1790033686
Name:JOB, ALISON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:JOB
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 1:2383 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:IL
Mailing Address - Zip Code:62236-2778
Mailing Address - Country:US
Mailing Address - Phone:314-221-6110
Mailing Address - Fax:
Practice Address - Street 1:2383 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:IL
Practice Address - Zip Code:62236-2778
Practice Address - Country:US
Practice Address - Phone:314-221-6110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120155221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical