Provider Demographics
NPI:1376322693
Name:GIESEN, ALEXANDER WILLIAM (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:WILLIAM
Last Name:GIESEN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 83RD AVE APT 2608
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3439
Mailing Address - Country:US
Mailing Address - Phone:651-271-2252
Mailing Address - Fax:
Practice Address - Street 1:16121 JAMAICA AVE FL 7
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6113
Practice Address - Country:US
Practice Address - Phone:718-896-2500
Practice Address - Fax:718-459-6542
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120254104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker