MEDICARE: ALISON M LANDONI LMHC

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
1	101YM0800X	Mental Health Counselor	13049	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13049	OTHER	MA	LMHC

General Provider Information

NPI Number	:	1255814315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON M LANDONI LMHC

Provider Business Mailing Address
First Line	:	3 BLACKBURN CTR
Second Line	:
City	:	GLOUCESTER
State	:	MA
Zip	:	01930-2268
Country	:	US
Telephone Number	:	978-491-6195
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 EASTERN AVE STE 106
Second Line	:
City	:	GLOUCESTER
State	:	MA
Zip	:	01930-1869
Country	:	US
Telephone Number	:	513-217-9991
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	06/10/2022

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