Provider Demographics
NPI:1619389749
Name:GOMES, ALICIA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:GOMES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 WARBLER DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5033
Mailing Address - Country:US
Mailing Address - Phone:863-205-8749
Mailing Address - Fax:
Practice Address - Street 1:3920 WARBLER DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-5033
Practice Address - Country:US
Practice Address - Phone:863-205-8749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW214041041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical