Individual
ALLISON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5 MOUNTAIN LAUREL, CLIFTON PARK, NY 12065-2217
(518) 847-5143
Mailing address
5 MOUNTAIN LAUREL, CLIFTON PARK, NY 12065-2217
(518) 847-5143
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
069310
NY
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00069310
—
NY
01
—
782073
MVP
—
Enumeration date
08/12/2006
Last updated
02/26/2025
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