Individual
ALYSSA CARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
225 N NOTRE DAME AVE STE 5, SOUTH BEND, IN 46617-2836
(517) 410-6093
Mailing address
55934 TETON CIR, MIDDLEBURY, IN 46540-8795
(517) 410-6093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007218A
IN
1041S0200X
School Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841657418
—
IN
Enumeration date
01/27/2016
Last updated
05/11/2022
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