Provider Demographics
NPI:1447139274
Name:STOUTEMIRE, ALICIA M (LCSW, PPSC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:STOUTEMIRE
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 E. TULARE AVE.
Mailing Address - Street 2:PO BOX 8858
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93747-8858
Mailing Address - Country:US
Mailing Address - Phone:559-312-5553
Mailing Address - Fax:
Practice Address - Street 1:2011 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1722
Practice Address - Country:US
Practice Address - Phone:559-547-3340
Practice Address - Fax:559-457-3373
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1181611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical