Provider Demographics
NPI:1972851400
Name:BRIGHT, ALICIA ROSE (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:ROSE
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6095 GREENE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROOK PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142
Mailing Address - Country:US
Mailing Address - Phone:440-567-7740
Mailing Address - Fax:
Practice Address - Street 1:29133 HEALTH CAMPUS DRIVE
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145
Practice Address - Country:US
Practice Address - Phone:440-835-6212
Practice Address - Fax:440-835-6231
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0901326104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker