Provider Demographics
NPI:1912789207
Name:ALICKI, ALYSSA M (LISW-CP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:ALICKI
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:ALICKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0174
Mailing Address - Country:US
Mailing Address - Phone:864-467-1177
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 174
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29602-0174
Practice Address - Country:US
Practice Address - Phone:864-467-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2025-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18357104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker