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NPI Code Detail

MEDICARE: ALICIA M LINQUIST MSW, LISW-S

MEDICARE: ALICIA M LINQUIST MSW, LISW-S
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
11041C0700XClinical Social WorkerI.1801279-SUPVOH

General Provider Information

NPI Number : 1871038158
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA M LINQUIST MSW, LISW-S
Provider Business Mailing Address
First Line : 4134 LINDEN AVE
Second Line :
City : DAYTON
State : OH
Zip : 45432-3043
Country : US
Telephone Number : 937-672-3459
Fax Number : 937-716-1809
Provider Business Practice Location Address
First Line : 4134 LINDEN AVE
Second Line :
City : DAYTON
State : OH
Zip : 45432-3043
Country : US
Telephone Number : 937-672-3459
Fax Number : 937-716-1809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2016
Last Update Date : 10/14/2025

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