Provider Demographics
NPI:1831723246
Name:PIGG, ALICIA (LPC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:PIGG
Suffix:
Gender:F
Credentials:LPC
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 95
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:VA
Mailing Address - Zip Code:24165-0095
Mailing Address - Country:US
Mailing Address - Phone:276-732-6660
Mailing Address - Fax:
Practice Address - Street 1:300 FRANKLIN ST STE 226
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2163
Practice Address - Country:US
Practice Address - Phone:276-638-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008845101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional