Provider Demographics
NPI:1699475079
Name:LOCKETT, ALICIA SHERPREE (LMSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:SHERPREE
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 BEAUMONT CV
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-5324
Mailing Address - Country:US
Mailing Address - Phone:901-857-9307
Mailing Address - Fax:
Practice Address - Street 1:2933 BEAUMONT CV
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-5324
Practice Address - Country:US
Practice Address - Phone:901-857-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM10085104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker