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NPI Code Detail

MEDICARE: ALLYSON CHRISTIANSON LCSW

MEDICARE:   ALLYSON  CHRISTIANSON  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW006451GA

General Provider Information

NPI Number : 1801387295
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON CHRISTIANSON LCSW
Provider Business Mailing Address
First Line : 1115 SYCAMORE AVE
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-7440
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1115 SYCAMORE AVE
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-7440
Country : US
Telephone Number : 912-399-7866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2018
Last Update Date : 05/22/2018

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Directions to “ ALLYSON CHRISTIANSON LCSW” Practice Location

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