Provider Demographics
NPI:1225462153
Name:POWELL, ALEXANDRA LAUREN (LCSW 88738)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:LAUREN
Last Name:POWELL
Suffix:
Gender:F
Credentials:LCSW 88738
Other - Prefix:MRS
Other - First Name:ALEXANDRA
Other - Middle Name:LAUREN
Other - Last Name:WEHRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5303
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92846-0303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23201 MILL CREEK DR STE 221
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7906
Practice Address - Country:US
Practice Address - Phone:888-795-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA887381041C0700X, 1041C0700X
CA67661104100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program