Provider Demographics
NPI:1578228664
Name:BRICKCHIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:BRICKCHIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:MAHOLCHIC
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:609-233-7878
Mailing Address - Street 1:2009 TIDEWATER COLONY DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2111
Mailing Address - Country:US
Mailing Address - Phone:609-233-7879
Mailing Address - Fax:
Practice Address - Street 1:2009 TIDEWATER COLONY DR STE 2A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2111
Practice Address - Country:US
Practice Address - Phone:609-233-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty