Provider Demographics
NPI:1982255618
Name:BRUSKI-WOODS, ALICIA LYNN (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LYNN
Last Name:BRUSKI-WOODS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 US HIGHWAY 23 N
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-8004
Mailing Address - Country:US
Mailing Address - Phone:989-356-4049
Mailing Address - Fax:
Practice Address - Street 1:1185 US HIGHWAY 23 N
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-8004
Practice Address - Country:US
Practice Address - Phone:989-356-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511151631041S0200X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician