Provider Demographics
NPI:1548854961
Name:SHIPMAN, ALICIA L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:L
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 W CAREFREE HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3202
Mailing Address - Country:US
Mailing Address - Phone:480-269-5415
Mailing Address - Fax:
Practice Address - Street 1:29216 N 20TH LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-2799
Practice Address - Country:US
Practice Address - Phone:480-269-5415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical