Alexandria D Licea, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60219 Issued in TX

Practice address

1325 N 63Rd St
Waco, TX 76710-4111

Phone

(254) 300-7591

NPI assigned

Jun 6, 2022

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• My Choice Counseling & Wellness, PLLC

  • Clinical Social Worker
  • New Braunfels, TX
  • NPI 1194348680
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1376272468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 STEPHENS PL STE 400A",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302167",
            "telephone_number": "830-282-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N 63RD ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104111",
            "telephone_number": "254-300-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICEA",
        "first_name": "ALEXANDRIA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isis Eboni Elise Lewis, LCSW
• Jamelah Lewis
• Stacy Lewis
• Hyoung Ill Lho, O.D.
• Zachary Libby, DC
• Kyna Baskin Lichtenstein, LCSW
• Edsel Ligutom Jr., PT
• Isaac Lill
• Thanh Nguyen Lill
• Emily Hope Lillard

• Clinical Social Worker in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.