Provider Demographics
NPI:1457835910
Name:ALIX, RICHARD R JR (MSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:R
Last Name:ALIX
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 RADMORE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1741
Mailing Address - Country:US
Mailing Address - Phone:508-752-8183
Mailing Address - Fax:
Practice Address - Street 1:26 RADMORE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1741
Practice Address - Country:US
Practice Address - Phone:508-752-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1055081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical