Healthcare Provider Details

I. General information

NPI: 1689732265
Provider Name (Legal Business Name): ALECIA JOY PRIESS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 MAPLE VALLEY ST
SANDUSKY MI
48471-1504
US

IV. Provider business mailing address

103 W MECHANIC ST APT 211
YALE MI
48097-3373
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-9020
  • Fax:
Mailing address:
  • Phone: 586-615-8991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801092079
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: