Provider Demographics
NPI:1528318615
Name:ELLINGSON, ALESHIA MARIE (LICSW)
Entity type:Individual
Prefix:
First Name:ALESHIA
Middle Name:MARIE
Last Name:ELLINGSON
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 1:1515 HANCOCK ST STE 303
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5243
Mailing Address - Country:US
Mailing Address - Phone:617-804-5575
Mailing Address - Fax:
Practice Address - Street 1:1515 HANCOCK ST STE 303
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5243
Practice Address - Country:US
Practice Address - Phone:617-804-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-15
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1206491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical