Provider Demographics
NPI:1851122568
Name:PETERS, ALECIA ZSANEEN (LCSW)
Entity type:Individual
Prefix:
First Name:ALECIA
Middle Name:ZSANEEN
Last Name:PETERS
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 1:1101 STONEWALL ST STE 602D
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1247
Mailing Address - Country:US
Mailing Address - Phone:469-278-6093
Mailing Address - Fax:
Practice Address - Street 1:1101 STONEWALL ST STE 602D
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1247
Practice Address - Country:US
Practice Address - Phone:469-278-6093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical