Provider Demographics
NPI:1073772620
Name:ALBANESE, ALICIA MARY (MS)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARY
Last Name:ALBANESE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 W JOHN ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1033
Mailing Address - Country:US
Mailing Address - Phone:516-935-6858
Mailing Address - Fax:
Practice Address - Street 1:385 W JOHN ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1033
Practice Address - Country:US
Practice Address - Phone:516-935-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health