Healthcare Provider Details

I. General information

NPI: 1063575686
Provider Name (Legal Business Name): ALCIRA OSAYI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. ALCIRA TEXIDOR

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 SATELLITE BLVD E-106
DULUTH GA
30097-6221
US

IV. Provider business mailing address

2255 SATELLITE BLVD APT E106
DULUTH GA
30097-6225
US

V. Phone/Fax

Practice location:
  • Phone: 678-957-0019
  • Fax: 678-957-0019
Mailing address:
  • Phone: 678-957-0019
  • Fax: 678-957-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW009301
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: