Provider Demographics
NPI:1629114996
Name:COLON, ALICIA REYES (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:REYES
Last Name:COLON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2486
Mailing Address - Country:US
Mailing Address - Phone:085-977-3723
Mailing Address - Fax:085-977-3460
Practice Address - Street 1:140 PARK ST STE 5
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-8048
Practice Address - Country:US
Practice Address - Phone:617-401-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1116841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical