Provider Demographics
NPI:1942885140
Name:MACON, ALLISON (LMSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MACON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 BARRETT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2004
Mailing Address - Country:US
Mailing Address - Phone:518-516-1080
Mailing Address - Fax:
Practice Address - Street 1:244 W WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2926
Practice Address - Country:US
Practice Address - Phone:607-737-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1067151041C0700X
NY24080291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161039939OtherALL OTHER INSURANCES
NY161039939Medicaid