Provider Demographics
NPI:1982639308
Name:GREINER, ALISON M (LCSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:GREINER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 HILL ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4724
Mailing Address - Country:US
Mailing Address - Phone:310-528-2110
Mailing Address - Fax:
Practice Address - Street 1:302 W GRAND AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3700
Practice Address - Country:US
Practice Address - Phone:310-784-7080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA219941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ42916Medicare UPIN
CASW21994Medicare ID - Type Unspecified