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General NPI Number Information
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NPI Number | 1215636212
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Entity Type | Individual
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Provider Name | ALYSSA HERNANDEZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 3580 MAIN ST
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City | HARTFORD
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State | CT
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Zip | 06120-1121
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Country | US
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Telephone | 860-778-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 180 SKOKORAT ST
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City | SEYMOUR
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State | CT
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Zip | 06483-3052
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Country | US
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Telephone | 203-278-9064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6764
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15498
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License Number State | CT
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