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NPI Code Detail

MEDICARE: ALISON MARIE UNDERWOOD LICSW

MEDICARE: ALISON MARIE UNDERWOOD LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker089-0001120VT

General Provider Information

NPI Number : 1164542965
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISON MARIE UNDERWOOD LICSW
Provider Business Mailing Address
First Line : 203 HAMILTON RD
Second Line :
City : WEYBRIDGE
State : VT
Zip : 05753-9666
Country : US
Telephone Number : 802-377-8142
Fax Number :
Provider Business Practice Location Address
First Line : 16 CREEK RD STE 2
Second Line :
City : MIDDLEBURY
State : VT
Zip : 05753-1574
Country : US
Telephone Number : 802-377-8142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 09/26/2024

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Directions to “ ALISON MARIE UNDERWOOD LICSW” Practice Location

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