Provider Demographics
NPI:1861998312
Name:ZWICK, ALISA (CDCA, PRS)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:ZWICK
Suffix:
Gender:F
Credentials:CDCA, PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10027 BELMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1103
Mailing Address - Country:US
Mailing Address - Phone:216-544-8062
Mailing Address - Fax:
Practice Address - Street 1:10027 BELMEADOW DR
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1103
Practice Address - Country:US
Practice Address - Phone:216-544-8062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH165073101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)