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General NPI Number Information
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NPI Number | 1124322730
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Entity Type | Individual
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Provider Name | ALICIA MARIE BRASS LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 12/23/2010
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 3518 W 25TH ST
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City | CLEVELAND
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State | OH
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Zip | 44109-1951
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Country | US
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Telephone | 216-320-1982
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Fax |
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Provider Business Mailing Address
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Address Line | 3279 GRENWAY RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-3411
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Country | US
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Telephone | 216-570-8508
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.0600612 SUPV
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License Number State | OH
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