Provider Demographics
NPI:1861706269
Name:BATISTA, ALICIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:BATISTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:BATISTA-SOBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 351
Mailing Address - Street 2:
Mailing Address - City:ALBRIGHTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18210-0351
Mailing Address - Country:US
Mailing Address - Phone:646-387-4533
Mailing Address - Fax:
Practice Address - Street 1:624 BEVERLEY RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3202
Practice Address - Country:US
Practice Address - Phone:718-972-6561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073844104100000X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool