Provider Demographics
NPI:1821301235
Name:CLARKE, ALISON CORNING (MSW)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:CORNING
Last Name:CLARKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4231
Mailing Address - Country:US
Mailing Address - Phone:781-686-9511
Mailing Address - Fax:
Practice Address - Street 1:208 VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4231
Practice Address - Country:US
Practice Address - Phone:781-686-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2140681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical