MEDICARE: ALICIA DEANNA REINE LCSW

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	104100000X	Social Worker	13442	LA

General Provider Information

NPI Number	:	1881149714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA DEANNA REINE LCSW

Provider Business Mailing Address
First Line	:	3100 RIDGELAKE DR STE 203
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-4938
Country	:	US
Telephone Number	:	504-638-6073
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 RIDGELAKE DR STE 203
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-4938
Country	:	US
Telephone Number	:	504-202-3205
Fax Number	:

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

Provider Enumeration Date	:	08/21/2016
Last Update Date	:	10/13/2020

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Directions to “ ALICIA DEANNA REINE LCSW” Practice Location

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