Provider Demographics
NPI:1912245358
Name:ALPERT, ALISON BRODY (DMIN, LCSW)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:BRODY
Last Name:ALPERT
Suffix:
Gender:F
Credentials:DMIN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PLACE, #21-B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:347-766-5580
Mailing Address - Fax:347-713-7745
Practice Address - Street 1:1115 BROADWAY FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3452
Practice Address - Country:US
Practice Address - Phone:347-766-5580
Practice Address - Fax:347-713-7745
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 171M00000X
NY0805031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04320696Medicaid
NY04320696Medicaid