Provider Demographics
NPI:1780384131
Name:FROST, ALYSSA RUTH (MSW, LCSW-A)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:RUTH
Last Name:FROST
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 BOLTONS MILL PKWY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5296
Mailing Address - Country:US
Mailing Address - Phone:385-515-6800
Mailing Address - Fax:
Practice Address - Street 1:2112 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2409
Practice Address - Country:US
Practice Address - Phone:757-826-7516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060142621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical