Provider Demographics
NPI:1033749577
Name:MIRANSKY, ALISON HOPE (LCSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:HOPE
Last Name:MIRANSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 CORDOVA RD STE 171
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2157
Mailing Address - Country:US
Mailing Address - Phone:954-728-2454
Mailing Address - Fax:954-603-2612
Practice Address - Street 1:1906 SW 6TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2001
Practice Address - Country:US
Practice Address - Phone:954-728-2454
Practice Address - Fax:954-603-2612
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW169491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical