Alicia Marie Johnson Bryant, LCSW
Social Worker, Clinical in Indianapolis, IN. Individual provider (NPI-1).
NPI number1578924924
StatusActive
Last updated in NPPESJan 9, 2024
Details
- NPI
- 1578924924
- Entity type
- Individual (NPI-1)
- Name
- Alicia Marie Johnson Bryant
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2016
- Certification date
- Jan 9, 2024
- Last updated
- Jan 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34008948A | IN | Yes |
| 104100000X | Social Worker | MSW005753 | GA | |
| 1041C0700X | Social Worker, Clinical | CSW007058 | GA |
Practice location
6530 Capricorn DrIndianapolis, IN 46237-4833
Phone 317-373-0749
Mailing address
6530 Capricorn DrIndianapolis, IN 46237-4833
Phone 317-373-0749
Other practice locations
950 N Meridian St
Indianapolis, IN 46204-1077
Indianapolis, IN 46204-1077
Phone 317-963-2200 · Fax 317-963-1621
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