Provider Demographics
NPI:1801371307
Name:POZNER, ALISA (LICSW)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:POZNER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 OUTLOOK RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-4114
Mailing Address - Country:US
Mailing Address - Phone:781-837-7979
Mailing Address - Fax:
Practice Address - Street 1:51 HATCH ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2449
Practice Address - Country:US
Practice Address - Phone:781-834-5030
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
MA1025686-103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool