Provider Demographics
NPI:1275246597
Name:KASPUTIS, ALEXANDRA (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KASPUTIS
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 31ST AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4980
Mailing Address - Country:US
Mailing Address - Phone:845-417-6757
Mailing Address - Fax:
Practice Address - Street 1:1142 31ST AVE APT 1A
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4980
Practice Address - Country:US
Practice Address - Phone:609-440-4786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health