Provider Demographics
NPI:1255992327
Name:DYAL, ALLISON (LMHC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:DYAL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1523 WILD IRIS LN
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-7071
Mailing Address - Country:US
Mailing Address - Phone:954-461-1393
Mailing Address - Fax:
Practice Address - Street 1:8823 SAN JOSE BLVD STE 301
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4290
Practice Address - Country:US
Practice Address - Phone:904-638-8164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMH1439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health