Provider Demographics
NPI:1184004855
Name:DEAN-MCCABE, ALISA MARGARET
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:MARGARET
Last Name:DEAN-MCCABE
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 1:2 HAGUE CT
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1719
Mailing Address - Country:US
Mailing Address - Phone:914-414-9003
Mailing Address - Fax:
Practice Address - Street 1:2 HAGUE CT
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1719
Practice Address - Country:US
Practice Address - Phone:914-414-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY889474251B00000X, 252Y00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency