Basic Information
Provider Information
NPI: 1215264759
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RISHTY
FirstName: ALLISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSW-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7474 GREENWAY CENTER DR
Address2: SUITE 730
City: GREENBELT
State: MD
PostalCode: 207703504
CountryCode: US
TelephoneNumber: 3013451022
FaxNumber: 3015605558
Practice Location
Address1: 16220 FREDERICK RD
Address2: SUITE 310
City: GAITHERSBURG
State: MD
PostalCode: 208774039
CountryCode: US
TelephoneNumber: 3013451022
FaxNumber: 3015605558
Other Information
ProviderEnumerationDate: 11/04/2009
LastUpdateDate: 06/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X14057MDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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