Provider Demographics
NPI:1750509238
Name:PICA, ALYSSA JANET (CMSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JANET
Last Name:PICA
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 TINY TOWN RD
Mailing Address - Street 2:APT 601
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4740
Mailing Address - Country:US
Mailing Address - Phone:931-503-0777
Mailing Address - Fax:
Practice Address - Street 1:621 TINY TOWN RD
Practice Address - Street 2:APT 601
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4740
Practice Address - Country:US
Practice Address - Phone:931-503-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health