Provider Demographics
NPI:1699920223
Name:HAVENS, ALICIA MICHELLE (LCSW-C)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MICHELLE
Last Name:HAVENS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MICHELLE
Other - Last Name:DELVALLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66 FL 3
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE STE 3
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1915
Practice Address - Country:US
Practice Address - Phone:551-996-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD144441041C0700X
NJ44SC053814001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical