Healthcare Provider Details

I. General information

NPI: 1548096795
Provider Name (Legal Business Name): ALICIA RENEE CATER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W PEARL ST
JERSEYVILLE IL
62052-1676
US

IV. Provider business mailing address

116 W PEARL ST
JERSEYVILLE IL
62052-1676
US

V. Phone/Fax

Practice location:
  • Phone: 618-310-3270
  • Fax: 618-310-3275
Mailing address:
  • Phone: 618-310-3270
  • Fax: 618-310-3275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: