Provider Demographics
NPI:1114458668
Name:KAJA, ALICIA M (LMSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:KAJA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5705 W JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1516
Mailing Address - Country:US
Mailing Address - Phone:231-286-1840
Mailing Address - Fax:
Practice Address - Street 1:5705 W JOHNSON RD
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1516
Practice Address - Country:US
Practice Address - Phone:231-425-4414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011041911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical