NPI 1225469059 · live from the CMS NPI Registry
Ivelise Alicea
Social Worker, Clinical in Bridgeport, CT. National Provider Identifier 1225469059, active.
NPI record
| NPI | 1225469059 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 46 Albion St, Bridgeport, CT 06605 |
| Practice phone | 203-330-6000 |
| Enumerated | December 4, 2013 |
| Last updated | December 30, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 010440 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.