Provider Demographics
NPI:1033423116
Name:ANDERSON, ALICIA NICHOLA (MSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:NICHOLA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TURNPIKE RD APT 134
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1044
Mailing Address - Country:US
Mailing Address - Phone:978-413-8893
Mailing Address - Fax:
Practice Address - Street 1:45 SUMMER ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3228
Practice Address - Country:US
Practice Address - Phone:978-534-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health