Provider Demographics
NPI:1528337524
Name:SPRINGER, ALISSA (LCSW)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:SPRINGER
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 1:125 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3064
Mailing Address - Country:US
Mailing Address - Phone:907-322-6584
Mailing Address - Fax:907-458-3054
Practice Address - Street 1:125 CHARLES ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3064
Practice Address - Country:US
Practice Address - Phone:907-322-6584
Practice Address - Fax:907-458-3054
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical