Healthcare Provider Details

I. General information

NPI: 1710322037
Provider Name (Legal Business Name): ALICIA ANN FISHLOCK MSW, CAPSW, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N3152 STATE ROAD 81
MONROE WI
53566-8821
US

IV. Provider business mailing address

N3152 STATE ROAD 81
MONROE WI
53566-8821
US

V. Phone/Fax

Practice location:
  • Phone: 608-328-9312
  • Fax:
Mailing address:
  • Phone: 608-328-9352
  • Fax: 608-328-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19699-130
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number135655
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: