MEDICARE: MS. ALICE MCCREERY L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LCS17285	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043351075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICE MCCREERY L.C.S.W.

Provider Business Mailing Address
First Line	:	3013 LONE JACK RD
Second Line	:
City	:	ENCINITAS
State	:	CA
Zip	:	92024-7008
Country	:	US
Telephone Number	:	858-442-1489
Fax Number	:	760-753-0687

Provider Business Practice Location Address
First Line	:	3435 CAMINO DEL RIO S
Second Line	:	SUITE 310
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3902
Country	:	US
Telephone Number	:	858-442-1489
Fax Number	:	760-753-0687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2007
Last Update Date	:	07/09/2007

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Directions to “ MS. ALICE MCCREERY L.C.S.W.” Practice Location

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