Provider Demographics
NPI:1427760891
Name:MELNICK, ALICIA D (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:MELNICK
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 1:2966 WILDWOOD ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2431
Mailing Address - Country:US
Mailing Address - Phone:740-381-3935
Mailing Address - Fax:
Practice Address - Street 1:2966 WILDWOOD ROAD EXT
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2431
Practice Address - Country:US
Practice Address - Phone:740-381-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0176001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical