Provider Demographics
NPI:1225219793
Name:CLASEN, ALYCE ANN (LCSW, LISW)
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:ANN
Last Name:CLASEN
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:ALYCE
Other - Middle Name:ANN GILES
Other - Last Name:CLASEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP
Mailing Address - Street 1:2039 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747-2022
Mailing Address - Country:US
Mailing Address - Phone:605-891-0913
Mailing Address - Fax:
Practice Address - Street 1:113 COMANCHE RD
Practice Address - Street 2:
Practice Address - City:FORT MEADE
Practice Address - State:SD
Practice Address - Zip Code:57741-1002
Practice Address - Country:US
Practice Address - Phone:605-745-2000
Practice Address - Fax:605-745-2878
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4571041C0700X
NE2061041C0700X
IA00031041C0700X
VA09040160451041C0700X
NE311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical