MEDICARE: ALAN LOUIS CIROCCO LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1068	AK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	800001335	OTHER	AK	MEDICARE ID -TYPE UNSPECIFIED

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790884807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN LOUIS CIROCCO LICSW

Provider Business Mailing Address
First Line	:	PO BOX 528
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-0528
Country	:	US
Telephone Number	:	907-543-6100
Fax Number	:	907-543-6008

Provider Business Practice Location Address
First Line	:	829 CHIEF EDDIE HOFFMAN HWY
Second Line	:
City	:	BETHEL
State	:	AK
Zip	:	99559-0528
Country	:	US
Telephone Number	:	907-543-6100
Fax Number	:	907-543-6008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	04/13/2011

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Directions to “ ALAN LOUIS CIROCCO LICSW” Practice Location

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