Provider Demographics
NPI:1053591925
Name:ALEGRIA, MICKEY R (MFT, LADC, EDS)
Entity type:Individual
Prefix:MR
First Name:MICKEY
Middle Name:R
Last Name:ALEGRIA
Suffix:
Gender:M
Credentials:MFT, LADC, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2248
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89505-2248
Mailing Address - Country:US
Mailing Address - Phone:775-741-4531
Mailing Address - Fax:775-828-9465
Practice Address - Street 1:738 PRATER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4466
Practice Address - Country:US
Practice Address - Phone:775-741-4531
Practice Address - Fax:775-828-9465
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV423101YA0400X
101YM0800X
NV0677106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health