Provider Demographics
NPI:1295159333
Name:ROBERTSON-ALI, ALAINE (LPC)
Entity type:Individual
Prefix:MS
First Name:ALAINE
Middle Name:
Last Name:ROBERTSON-ALI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2224
Mailing Address - Country:US
Mailing Address - Phone:917-294-8287
Mailing Address - Fax:
Practice Address - Street 1:64 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2224
Practice Address - Country:US
Practice Address - Phone:917-294-8287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00571000101YP2500X
NY002654-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health