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General NPI Number Information
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NPI Number | 1043934185
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Entity Type | Individual
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Provider Name | ALICIA BUSIC LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 3908 N PENIEL AVE STE 500
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City | BETHANY
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State | OK
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Zip | 73008-3402
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Country | US
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Telephone | 405-397-1617
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Fax |
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Provider Business Mailing Address
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Address Line | 3408 NW 189TH ST
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City | EDMOND
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State | OK
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Zip | 73012-0007
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Country | US
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Telephone | 405-397-1617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW19111
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License Number State | FL
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