Provider Demographics
NPI:1679842041
Name:SETKA, ALISON M (MA/MFT, ICADC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:SETKA
Suffix:
Gender:F
Credentials:MA/MFT, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 ROSE ANNE LOOP
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-6063
Mailing Address - Country:US
Mailing Address - Phone:210-259-1663
Mailing Address - Fax:
Practice Address - Street 1:7203 BALTZELL AVENUE BUILDING 324
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-545-8367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1575-10101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)