Provider Demographics
NPI:1164542965
Name:UNDERWOOD, ALISON MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:WEYBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05753-9666
Mailing Address - Country:US
Mailing Address - Phone:802-377-8142
Mailing Address - Fax:
Practice Address - Street 1:16 CREEK RD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1574
Practice Address - Country:US
Practice Address - Phone:802-377-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00011201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical