Provider Demographics
NPI:1568037976
Name:INSERRA, ALEXA L (LMHC)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:L
Last Name:INSERRA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 KRAMER AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-4226
Mailing Address - Country:US
Mailing Address - Phone:347-853-6151
Mailing Address - Fax:
Practice Address - Street 1:227 KRAMER AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-4226
Practice Address - Country:US
Practice Address - Phone:347-853-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional