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NPI Code Detail

MEDICARE: LISA A ALLEN LCSW

MEDICARE: LISA A ALLEN LCSW
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
1101YM0800XMental Health Counselor072295-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1072295-1OTHERNYLCSW

General Provider Information

NPI Number : 1578599502
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA A ALLEN LCSW
Provider Business Mailing Address
First Line : 85 BRINKERHOFF ST
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12901-2729
Country : US
Telephone Number : 518-578-3380
Fax Number :
Provider Business Practice Location Address
First Line : 22 US OVAL STE 123
Second Line :
City : PLATTSBURGH
State : NY
Zip : 12903-5901
Country : US
Telephone Number : 518-578-3380
Fax Number : 518-566-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 05/20/2024

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