Provider Demographics
NPI:1932520970
Name:KOCHAN, ALICIA (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:KOCHAN
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:BIANCHETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40612 REHSE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4136
Mailing Address - Country:US
Mailing Address - Phone:586-549-3046
Mailing Address - Fax:
Practice Address - Street 1:37400 GARFIELD RD STE 130
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3648
Practice Address - Country:US
Practice Address - Phone:586-738-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851118719104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker