| Alicia Mittleman Licensed Clinical Social Worker Counseling Services | |
|
3880 Fowler Rd West Sacramento CA 95691-5491 | |
| (916) 425-7733 | |
| (916) 372-2466 |
| Full Name | Alicia Mittleman Licensed Clinical Social Worker Counseling Services |
|---|---|
| Speciality | Social Worker |
| Location | 3880 Fowler Rd, West Sacramento, California |
| Authorized Official Name and Position | Alicia Laurel Mittleman (CEO) |
| Authorized Official Contact | 9164257733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alicia Mittleman Licensed Clinical Social Worker Counseling Services 3880 Fowler Rd West Sacramento CA 95691-5491 Ph: (916) 425-7733 | Alicia Mittleman Licensed Clinical Social Worker Counseling Services 3880 Fowler Rd West Sacramento CA 95691-5491 Ph: (916) 425-7733 |
| NPI Number | 1588171730 |
|---|---|
| Provider Enumeration Date | 01/09/2018 |
| Last Update Date | 02/13/2023 |
| Certification Date | 02/13/2023 |
| Medicare PECOS PAC ID | 8022372952 |
|---|---|
| Medicare Enrollment ID | O20180910002567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588171730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 28794 (California) | Primary |
| Provider Name | Alicia L Mittleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205291044 PECOS PAC ID: 5395028922 Enrollment ID: I20170206002030 |
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