Provider Demographics
NPI:1366989576
Name:AHERN, ALISA JANET (LMSW)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:JANET
Last Name:AHERN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:JANET
Other - Last Name:ORLINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:34 FIRE ROAD DR
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-3947
Mailing Address - Country:US
Mailing Address - Phone:631-666-1951
Mailing Address - Fax:631-593-5472
Practice Address - Street 1:269 W MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8319
Practice Address - Country:US
Practice Address - Phone:631-666-1951
Practice Address - Fax:631-593-5472
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081277104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker