Provider Demographics
NPI:1275877193
Name:LEDUC, ALEXANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:LEDUC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10548 BARDILINO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-4252
Mailing Address - Country:US
Mailing Address - Phone:949-412-1638
Mailing Address - Fax:
Practice Address - Street 1:2801 S VALLEY VIEW BLVD
Practice Address - Street 2:#6
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0116
Practice Address - Country:US
Practice Address - Phone:702-922-7015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6343-S1041C0700X
NV6835-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical