Healthcare Provider Details

I. General information

NPI: 1003593930
Provider Name (Legal Business Name): ALLYSON LAFON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 MEDIC WAY
GREENCASTLE IN
46135-2296
US

IV. Provider business mailing address

112 S MADISON ST
GREENCASTLE IN
46135-1654
US

V. Phone/Fax

Practice location:
  • Phone: 888-714-1926
  • Fax:
Mailing address:
  • Phone: 317-801-5736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: