Provider Demographics
NPI:1225575335
Name:MARTIN PRESSLEY, ALICEA (MSW LISW-S)
Entity Type:Individual
Prefix:
First Name:ALICEA
Middle Name:
Last Name:MARTIN PRESSLEY
Suffix:
Gender:F
Credentials:MSW LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-0504
Mailing Address - Country:US
Mailing Address - Phone:513-371-1161
Mailing Address - Fax:513-649-8349
Practice Address - Street 1:6554 LITCHFIELD LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-9230
Practice Address - Country:US
Practice Address - Phone:513-371-1161
Practice Address - Fax:513-649-8349
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131038-3101YA0400X
OHI.1700735101YM0800X, 1041C0700X
OHS09012921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH82-4369088Medicaid