Provider Demographics
NPI:1891035630
Name:NYMAN, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:NYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 NW 81ST TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4663
Mailing Address - Country:US
Mailing Address - Phone:954-648-5153
Mailing Address - Fax:
Practice Address - Street 1:3325 HOLLYWOOD BLVD STE 503
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6926
Practice Address - Country:US
Practice Address - Phone:954-648-5153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086976104100000X
FLSW142421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW14242OtherLCSW