Provider Demographics
NPI:1932852019
Name:GUY, ALICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:GUY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E LAKE AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-2090
Mailing Address - Country:US
Mailing Address - Phone:847-707-7415
Mailing Address - Fax:
Practice Address - Street 1:1701 E LAKE AVE STE 370
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-2090
Practice Address - Country:US
Practice Address - Phone:847-707-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-30
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0143171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical