Provider Demographics
NPI:1437885928
Name:PRESCOTT, ALEX JAY
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:JAY
Last Name:PRESCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 RILEY AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1645
Mailing Address - Country:US
Mailing Address - Phone:518-928-9143
Mailing Address - Fax:
Practice Address - Street 1:210 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1010
Practice Address - Country:US
Practice Address - Phone:518-580-0520
Practice Address - Fax:518-580-9975
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health