Provider Demographics
NPI:1992942700
Name:BIRNBAUM, ALISON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:
Last Name:BIRNBAUM
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 1:22 OLD STUDIO RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-6622
Mailing Address - Country:US
Mailing Address - Phone:203-966-9770
Mailing Address - Fax:203-966-2208
Practice Address - Street 1:22 OLD STUDIO RD
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-6622
Practice Address - Country:US
Practice Address - Phone:203-966-9770
Practice Address - Fax:203-966-2208
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0013761041C0700X
NY0276331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027633OtherSTATE OF NEW YORK
CT001376OtherSTATE OF CT