Provider Demographics
NPI:1518008572
Name:UMSTEAD, ALEXANDRA N (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:N
Last Name:UMSTEAD
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 1:3904 OLEANDER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6717
Mailing Address - Country:US
Mailing Address - Phone:910-790-9500
Mailing Address - Fax:910-796-8111
Practice Address - Street 1:3904 OLEANDER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6717
Practice Address - Country:US
Practice Address - Phone:910-790-9500
Practice Address - Fax:910-796-8111
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002833Medicaid