Provider Demographics
NPI:1376840868
Name:MCDERMOTT, ALISHA BRITT (MA PLPC)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:BRITT
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:MA PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12166 OLD BIG BEND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6844
Mailing Address - Country:US
Mailing Address - Phone:314-717-0190
Mailing Address - Fax:314-754-7275
Practice Address - Street 1:12166 OLD BIG BEND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6844
Practice Address - Country:US
Practice Address - Phone:314-717-0190
Practice Address - Fax:314-754-7275
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011000672101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health