Organization
ALAN ICKOWITZ, PSY.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN Y ICKOWITZ PSY.D. (PRESIDENT)
(813) 814-9839
Entity
Organization
Contact information
Practice address
6105 MEMORIAL HWY, STE B, TAMPA, FL 33615-4597
(813) 814-9839
(813) 200-1044
Mailing address
6105 MEMORIAL HWY, STE B, TAMPA, FL 33615-4597
(813) 814-9839
(813) 200-1044
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY5649
FL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY5649
FL
103TC0700X
Clinical Psychologist
Primary
PY5649
FL
Other
Enumeration date
03/26/2007
Last updated
09/11/2025
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