Provider Demographics
NPI:1538270236
Name:NOWARK, ALICE (LMFT)
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:
Last Name:NOWARK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 STONEY DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-2228
Mailing Address - Country:US
Mailing Address - Phone:315-472-4471
Mailing Address - Fax:315-472-1759
Practice Address - Street 1:324 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1811
Practice Address - Country:US
Practice Address - Phone:315-472-4471
Practice Address - Fax:315-472-1759
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist