Provider Demographics
NPI:1629706825
Name:QUIGLEY-HOLMBECK, ALISIA NICOLE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALISIA
Middle Name:NICOLE
Last Name:QUIGLEY-HOLMBECK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:ALISIA
Other - Middle Name:NICOLE
Other - Last Name:QUIGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:9364 E 1175TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61326-9486
Mailing Address - Country:US
Mailing Address - Phone:815-343-2636
Mailing Address - Fax:
Practice Address - Street 1:1431 LOURDES RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:IL
Practice Address - Zip Code:61548-7609
Practice Address - Country:US
Practice Address - Phone:815-343-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0246971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical