1619035714 NPI number — ALISON OWEN TODD M.S.W., LICSW

Table of content: ALISON OWEN TODD M.S.W., LICSW (NPI 1619035714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619035714 NPI number — ALISON OWEN TODD M.S.W., LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TODD
Provider First Name:
ALISON
Provider Middle Name:
OWEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619035714
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 373
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORTHINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01098-0373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-584-6464
Provider Business Mailing Address Fax Number:
413-238-5810

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
78 MAIN ST
Provider Second Line Business Practice Location Address:
STE 209
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-3111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-584-6464
Provider Business Practice Location Address Fax Number:
413-238-5810
Provider Enumeration Date:
12/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  113134 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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