Provider Demographics
NPI:1902147200
Name:WU, ALICIA (MHC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MULBERRY ST # 38
Mailing Address - Street 2:APT. 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4347
Mailing Address - Country:US
Mailing Address - Phone:732-995-1640
Mailing Address - Fax:
Practice Address - Street 1:8020 45TH AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3545
Practice Address - Country:US
Practice Address - Phone:718-478-2900
Practice Address - Fax:718-478-3456
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health