Healthcare Provider Details

I. General information

NPI: 1174923395
Provider Name (Legal Business Name): ALICIA WRESINSKI CAPRAZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1209 S MAIN ST
STILLWATER OK
74074-5846
US

IV. Provider business mailing address

7533 MAIN ST
SYKESVILLE MD
21784-7374
US

V. Phone/Fax

Practice location:
  • Phone: 405-564-3408
  • Fax:
Mailing address:
  • Phone: 410-970-6964
  • Fax: 410-970-6157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6830
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30980
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: