Provider Demographics
NPI:1447783113
Name:CLEMENT, ALICIA (LPC, NCC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 KENT LN
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3391
Mailing Address - Country:US
Mailing Address - Phone:517-740-0719
Mailing Address - Fax:
Practice Address - Street 1:3531 RAVINEWOOD CT
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-1648
Practice Address - Country:US
Practice Address - Phone:517-740-0719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010852101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional