Healthcare Provider Details

I. General information

NPI: 1003234469
Provider Name (Legal Business Name): ALISON BRASSARD L'HEUREUX LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 N MAIN ST
FLORENCE MA
01062-1287
US

IV. Provider business mailing address

8 ATWOOD DR
NORTHAMPTON MA
01060-4272
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-5382
  • Fax: 413-582-1832
Mailing address:
  • Phone: 413-773-1314
  • Fax: 413-774-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111759
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: