MEDICARE: MRS. ALICIA KOCHAN LLMSW

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	6851118719	MI

General Provider Information

NPI Number	:	1932520970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA KOCHAN LLMSW

Provider Business Mailing Address
First Line	:	40612 REHSE DR
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-4136
Country	:	US
Telephone Number	:	586-549-3046
Fax Number	:

Provider Business Practice Location Address
First Line	:	37400 GARFIELD RD STE 130
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48036-3648
Country	:	US
Telephone Number	:	586-738-6518
Fax Number	:

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

Provider Enumeration Date	:	12/18/2013
Last Update Date	:	10/08/2024

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