Healthcare Provider Details

I. General information

NPI: 1003350455
Provider Name (Legal Business Name): ALLISON PINA LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

906 POINT RD
MARION MA
02738-1215
US

IV. Provider business mailing address

33 ARTHUR AVE APT 17
E PROVIDENCE RI
02914-4019
US

V. Phone/Fax

Practice location:
  • Phone: 443-834-6973
  • Fax: 508-306-8061
Mailing address:
  • Phone: 443-834-6973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number120097
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: