=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376850768
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALISON C DYE LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2010
-----------------------------------------------------
Last Update Date | 09/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 138 W 25TH ST 8TH FLOOR ROOM B-9
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-7405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-594-5174
-----------------------------------------------------
Fax | 845-331-1566
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 46 JOSEPHINE AVE
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12401-5300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-594-5174
-----------------------------------------------------
Fax | 845-331-1566
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 017051
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------