Basic Information
| Provider Information | |||||||||
| NPI: | 1396821609 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CURRY | ||||||||
| FirstName: | ALYSON | ||||||||
| MiddleName: | BLAKE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LCSW-R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 CAREY RD | ||||||||
| Address2: | |||||||||
| City: | QUEENSBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128047880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5187610300 | ||||||||
| FaxNumber: | 5188242388 | ||||||||
| Practice Location | |||||||||
| Address1: | 828 STATE ROUTE 11 | ||||||||
| Address2: | |||||||||
| City: | CHAMPLAIN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 129194966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182982691 | ||||||||
| FaxNumber: | 5182988241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2006 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R040590 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 02836395 | 05 | NY | MEDICAID |