Provider Demographics
NPI:1104493469
Name:EAD, ALICIA (LICSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:EAD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MARIA ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1400
Mailing Address - Country:US
Mailing Address - Phone:401-556-1149
Mailing Address - Fax:
Practice Address - Street 1:1443 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3224
Practice Address - Country:US
Practice Address - Phone:401-556-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
RIISW043121041C0700X
RICSW026541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical