MEDICARE: MS. ALICIA ANNE STALKER LMFT

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	106H00000X	Marriage & Family Therapist	166.001066	IL
2	106H00000X	Marriage & Family Therapist	MFC42067	CA

General Provider Information

NPI Number	:	1962540716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALICIA ANNE STALKER LMFT

Provider Business Mailing Address
First Line	:	105 E MAIN ST STE 302
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2149
Country	:	US
Telephone Number	:	815-322-3238
Fax Number	:	708-827-0454

Provider Business Practice Location Address
First Line	:	105 E MAIN ST STE 302
Second Line	:
City	:	MORRIS
State	:	IL
Zip	:	60450-2149
Country	:	US
Telephone Number	:	815-322-3238
Fax Number	:	708-827-0454

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	04/12/2026

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