Provider Demographics
NPI:1538591755
Name:KO, ALISON MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:MARIE
Last Name:KO
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 1:35 BOGERT PL
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-1808
Mailing Address - Country:US
Mailing Address - Phone:201-664-0358
Mailing Address - Fax:
Practice Address - Street 1:35 BOGERT PL
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1808
Practice Address - Country:US
Practice Address - Phone:201-664-0358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073978-1171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator