Provider Demographics
NPI:1649852724
Name:WOODS, ALYSSA NICOLE (MA, LPC, CAADC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:NICOLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:MA, LPC, CAADC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:NICOLE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, NCC
Mailing Address - Street 1:31 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:GOULDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18424-8820
Mailing Address - Country:US
Mailing Address - Phone:570-878-8201
Mailing Address - Fax:
Practice Address - Street 1:31 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:GOULDSBORO
Practice Address - State:PA
Practice Address - Zip Code:18424-8820
Practice Address - Country:US
Practice Address - Phone:570-878-8201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013196101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor