Provider Demographics
NPI:1073727764
Name:ALEXANDER, REBECCA ANN (LMSW, MPH)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LMSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 65TH ST
Mailing Address - Street 2:APT 11H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6943
Mailing Address - Country:US
Mailing Address - Phone:917-806-0323
Mailing Address - Fax:
Practice Address - Street 1:401 E 65TH ST
Practice Address - Street 2:APT 11H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6943
Practice Address - Country:US
Practice Address - Phone:917-806-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0788001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY078800OtherNEW YORK STATE LCSW LICENSE NUMBER