Provider Demographics
NPI:1184922940
Name:POHLMAN, ALLISON E (LCSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:POHLMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:E
Other - Last Name:AUGUSTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APSW
Mailing Address - Street 1:1496 BELLEVUE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4205
Mailing Address - Country:US
Mailing Address - Phone:920-784-2644
Mailing Address - Fax:920-784-2655
Practice Address - Street 1:1496 BELLEVUE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4205
Practice Address - Country:US
Practice Address - Phone:920-784-2644
Practice Address - Fax:920-784-2655
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100029360Medicaid
K400169479Medicare PIN