Provider Demographics
NPI:1356793111
Name:PROBLYNN, ALYSHA (LCSW)
Entity type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:PROBLYNN
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 1:6 AUTOMATION LN STE 105
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1658
Mailing Address - Country:US
Mailing Address - Phone:518-360-1534
Mailing Address - Fax:
Practice Address - Street 1:6 AUTOMATION LN STE 105
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1658
Practice Address - Country:US
Practice Address - Phone:518-360-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088427-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical