Provider Demographics
NPI:1861682197
Name:VON SCHIRACH, ALICIA (PHD, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:VON SCHIRACH
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144456
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4456
Mailing Address - Country:US
Mailing Address - Phone:305-993-9413
Mailing Address - Fax:305-779-4974
Practice Address - Street 1:2655 S. LEJEUNE ROAD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5816
Practice Address - Country:US
Practice Address - Phone:305-993-9413
Practice Address - Fax:305-779-4974
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional