Provider Demographics
NPI:1063974681
Name:NASH, ALYSON SHINNERS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:SHINNERS
Last Name:NASH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 N LINCOLN AVE STE 224A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3122
Mailing Address - Country:US
Mailing Address - Phone:773-350-3842
Mailing Address - Fax:
Practice Address - Street 1:3139 N LINCOLN AVE STE 224A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3122
Practice Address - Country:US
Practice Address - Phone:773-350-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0077081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical