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NPI Code Detail

MEDICARE: ALLISON WELSH LCSW

MEDICARE: ALLISON WELSH 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
11041C0700XClinical Social Worker83138CA

General Provider Information

NPI Number : 1902445562
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON WELSH LCSW
Provider Business Mailing Address
First Line : 11823 SORTINO CT
Second Line :
City : MOORPARK
State : CA
Zip : 93021-3346
Country : US
Telephone Number : 805-807-9381
Fax Number :
Provider Business Practice Location Address
First Line : 5743 CORSA AVE STE 221
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91362-6451
Country : US
Telephone Number : 805-334-0379
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2019
Last Update Date : 12/31/2019

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