Provider Demographics
NPI:1376026971
Name:HARLOW, ALISSA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:
Last Name:HARLOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:533 26TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2459
Mailing Address - Country:US
Mailing Address - Phone:801-801-3745
Mailing Address - Fax:
Practice Address - Street 1:533 26TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2459
Practice Address - Country:US
Practice Address - Phone:801-801-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12923578-35011041C0700X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No172V00000XOther Service ProvidersCommunity Health Worker