Provider Demographics
NPI:1467284752
Name:PAKER, ALYSSA ROCHELLE (MHC-LP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ROCHELLE
Last Name:PAKER
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 DUNCAN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CORNWALL ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12520-1449
Mailing Address - Country:US
Mailing Address - Phone:845-282-6748
Mailing Address - Fax:
Practice Address - Street 1:28 DUNCAN AVE APT 2
Practice Address - Street 2:
Practice Address - City:CORNWALL ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12520-1449
Practice Address - Country:US
Practice Address - Phone:845-282-6748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health