Doctor Name: | ALYSSA STARCK |
NPI Number: | 1003276486 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | |
Business Practice Address: | 2057 S 14th St Milwaukee, WI - 532043847 |
Business Phone Number: | 4146438778 |
Business Fax Number: | |
Mailing Address: | 2057 S 14th St, MILWAUKEE |
State: | WI |
Postal Code: | 532043847 |
Phone Number: | 4146438778 |
Fax Number: | |
NPI Enumeration Date: | 02/29/2016 |
NPI Last Update Date: | 02/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |