Basic Information
Provider Information
NPI: 1003014580
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLER
FirstName: CAROLINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 24 S PROSPECT ST
Address2:  
City: AMHERST
State: MA
PostalCode: 010023802
CountryCode: US
TelephoneNumber: 4138351558
FaxNumber: 8662407441
Practice Location
Address1: 24 S PROSPECT ST
Address2:  
City: AMHERST
State: MA
PostalCode: 010023802
CountryCode: US
TelephoneNumber: 4138351558
FaxNumber: 8662407441
Other Information
ProviderEnumerationDate: 07/06/2007
LastUpdateDate: 10/07/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X116209MAY Behavioral Health & Social Service ProvidersSocial WorkerClinical
174400000X  N Other Service ProvidersSpecialist 

No ID Information.


Home