Provider Demographics
NPI:1528767225
Name:CAIN, ALYSSA LEE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LEE
Last Name:CAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:LEE
Other - Last Name:ZUCKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1904 STONERIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MARRIOTTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21104-1023
Mailing Address - Country:US
Mailing Address - Phone:808-352-8606
Mailing Address - Fax:
Practice Address - Street 1:7533 MAIN ST STE 1F
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-5308
Practice Address - Country:US
Practice Address - Phone:410-988-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208190363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health