Provider Demographics
NPI:1932814092
Name:MEANS-LOONEY, ALISA M (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:M
Last Name:MEANS-LOONEY
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36750 THEODORE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1955
Mailing Address - Country:US
Mailing Address - Phone:586-991-1052
Mailing Address - Fax:
Practice Address - Street 1:36750 THEODORE ST
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-1955
Practice Address - Country:US
Practice Address - Phone:586-991-1052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511106391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty