Provider Demographics
NPI:1265737654
Name:WOZARIK, ALLISON MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MICHELLE
Last Name:WOZARIK
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 1:88 MAIN ST S
Mailing Address - Street 2:SUITE A205
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2276
Mailing Address - Country:US
Mailing Address - Phone:203-262-8150
Mailing Address - Fax:203-262-8152
Practice Address - Street 1:88 MAIN ST S
Practice Address - Street 2:SUITE A205
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2276
Practice Address - Country:US
Practice Address - Phone:203-262-8150
Practice Address - Fax:203-262-8152
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0073781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008031053Medicaid