Provider Demographics
NPI:1851026967
Name:PHILLIPS, ALISON RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:RAE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:RAE
Other - Last Name:PHILLIPS-COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1729 E EPLER AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-4603
Mailing Address - Country:US
Mailing Address - Phone:317-403-7277
Mailing Address - Fax:
Practice Address - Street 1:1729 E EPLER AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-4603
Practice Address - Country:US
Practice Address - Phone:317-403-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006812A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical