Provider Demographics
NPI:1053455451
Name:BONE, ALICIA BONE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:BONE
Last Name:BONE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1586 KAMELA DR S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2249
Mailing Address - Country:US
Mailing Address - Phone:503-391-6823
Mailing Address - Fax:
Practice Address - Street 1:1586 KAMELA DR S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97306-2249
Practice Address - Country:US
Practice Address - Phone:503-391-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1102101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional