Provider Demographics
NPI:1548095466
Name:PIRAKA, ALICIA MCCORMICK (LMSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MCCORMICK
Last Name:PIRAKA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 HILLSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48198-9663
Mailing Address - Country:US
Mailing Address - Phone:734-845-7150
Mailing Address - Fax:
Practice Address - Street 1:202 E WASHINGTON ST STE 308
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2051
Practice Address - Country:US
Practice Address - Phone:734-845-7150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011039681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical