Provider Demographics
NPI:1659118388
Name:MCNALLY, ALISON MAE (LMHC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MAE
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:MAE
Other - Last Name:SHUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:851 BROKEN SOUND PKWY NW
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3616
Mailing Address - Country:US
Mailing Address - Phone:954-663-0451
Mailing Address - Fax:
Practice Address - Street 1:851 BROKEN SOUND PKWY NW
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3616
Practice Address - Country:US
Practice Address - Phone:561-278-6033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH24003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty