Provider Demographics
NPI:1386996312
Name:LEVINE, ALISON (LMSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-2266
Mailing Address - Country:US
Mailing Address - Phone:518-477-7535
Mailing Address - Fax:518-477-7555
Practice Address - Street 1:743 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-2266
Practice Address - Country:US
Practice Address - Phone:518-477-7535
Practice Address - Fax:518-477-7555
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084934-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker