Healthcare Provider Details

I. General information

NPI: 1225575335
Provider Name (Legal Business Name): ALICEA MARTIN PRESSLEY MSW LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6554 LITCHFIELD LN
MIDDLETOWN OH
45042-9230
US

IV. Provider business mailing address

PO BOX 504
MIDDLETOWN OH
45042-0504
US

V. Phone/Fax

Practice location:
  • Phone: 513-371-1161
  • Fax: 513-649-8349
Mailing address:
  • Phone: 513-371-1161
  • Fax: 513-649-8349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number131038-3
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberI.1700735
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS0901292
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1700735
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: