Provider Demographics
NPI:1124689682
Name:NOONE, ALLISON LIN (LSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LIN
Last Name:NOONE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:POLTANIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 LYNCH ST
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-1635
Mailing Address - Country:US
Mailing Address - Phone:570-280-6970
Mailing Address - Fax:
Practice Address - Street 1:1801 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:PA
Practice Address - Zip Code:18447-1365
Practice Address - Country:US
Practice Address - Phone:570-961-3361
Practice Address - Fax:570-961-3364
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136141104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker