Provider Demographics
NPI:1821118712
Name:HUMPLIK, ALLISON MONACO (MSW, LISW-CP/S)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MONACO
Last Name:HUMPLIK
Suffix:
Gender:F
Credentials:MSW, LISW-CP/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 ROCKFISH CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7988
Mailing Address - Country:US
Mailing Address - Phone:904-536-6276
Mailing Address - Fax:
Practice Address - Street 1:3301 SALTERBECK ST STE 101
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7165
Practice Address - Country:US
Practice Address - Phone:904-536-6276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW39291041C0700X
PACW0161751041C0700X
SC10177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical