Provider Demographics
NPI:1790260263
Name:ROTHSCHILD, ALLISON WEISS (LICSW, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:WEISS
Last Name:ROTHSCHILD
Suffix:
Gender:F
Credentials:LICSW, BCBA, LABA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RACHEL
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW, BCBA
Mailing Address - Street 1:81 HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2212
Mailing Address - Country:US
Mailing Address - Phone:774-452-2655
Mailing Address - Fax:
Practice Address - Street 1:81 HOPE AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2212
Practice Address - Country:US
Practice Address - Phone:774-452-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1163291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical