Basic Information
| Provider Information | |||||||||
| NPI: | 1669982989 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES ALLISON, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 BROADWAY STE 204 | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124013449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453941156 | ||||||||
| FaxNumber: | 8666195710 | ||||||||
| Practice Location | |||||||||
| Address1: | 721 BROADWAY STE 204 | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124013449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453941156 | ||||||||
| FaxNumber: | 8666195710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2017 | ||||||||
| LastUpdateDate: | 06/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | ALLISON | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER | ||||||||
| AuthorizedOfficialTelephone: | 8455941156 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 082296 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.