MEDICARE: ALLISON NICOLE LOSEE 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
1	1041C0700X	Clinical Social Worker	115016	TX
2	1041C0700X	Clinical Social Worker	SW23747	FL

General Provider Information

NPI Number	:	1851116461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON NICOLE LOSEE LCSW

Provider Business Mailing Address
First Line	:	4345 LAGUARDIA LN APT 4204
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-3514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 N CARROLL AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-6613
Country	:	US
Telephone Number	:	214-887-6580
Fax Number	:

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

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	03/20/2026

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