Healthcare Provider Details

I. General information

NPI: 1174188841
Provider Name (Legal Business Name): ALLISON MARGOLIS PMHNP-BC, LICSW, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

IV. Provider business mailing address

82 WENDELL AVE STE 100
PITTSFIELD MA
01201-7066
US

V. Phone/Fax

Practice location:
  • Phone: 617-237-0839
  • Fax: 617-674-0327
Mailing address:
  • Phone:
  • Fax: 617-674-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2390392
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2390392
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: