Provider Demographics
NPI:1003350455
Name:PINA, ALLISON (LICSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PINA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ARTHUR AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:E PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-4019
Mailing Address - Country:US
Mailing Address - Phone:443-834-6973
Mailing Address - Fax:
Practice Address - Street 1:906 POINT RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1215
Practice Address - Country:US
Practice Address - Phone:443-834-6973
Practice Address - Fax:508-306-8061
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1200971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical