Provider Demographics
NPI:1063118982
Name:MCBRIDE, ALIZIA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALIZIA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:ALIZIA
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4018 ROANOKE RD LOWR UNIT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3929
Mailing Address - Country:US
Mailing Address - Phone:404-935-2868
Mailing Address - Fax:
Practice Address - Street 1:5600 MONROE ST STE 103B
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2795
Practice Address - Country:US
Practice Address - Phone:419-885-5952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204445101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health