Provider Demographics
NPI:1063220689
Name:SWARTZ, ALYSSA J
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:J
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:J
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22 ROLLINSON RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-1518
Mailing Address - Country:US
Mailing Address - Phone:774-296-4309
Mailing Address - Fax:
Practice Address - Street 1:255 PARK AVE STE 412
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1989
Practice Address - Country:US
Practice Address - Phone:508-756-5400
Practice Address - Fax:508-756-5433
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor