Provider Demographics
NPI:1306976469
Name:VINSON, ALLISON E (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:E
Last Name:VINSON
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 1:151 MARY ESTHER BLVD STE 308A
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-1974
Mailing Address - Country:US
Mailing Address - Phone:850-305-1832
Mailing Address - Fax:
Practice Address - Street 1:151 MARY ESTHER BLVD STE 308A
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-1974
Practice Address - Country:US
Practice Address - Phone:850-305-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051931041C0700X
FLSW98571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical