Provider Demographics
NPI:1598972341
Name:ALEXANDER, NANCY JOAN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JOAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 LITTLE PATUXENT PKWY
Mailing Address - Street 2:SUITE 223
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3273
Mailing Address - Country:US
Mailing Address - Phone:410-730-8780
Mailing Address - Fax:410-730-8781
Practice Address - Street 1:10632 LITTLE PATUXENT PKWY
Practice Address - Street 2:SUITE 223
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3273
Practice Address - Country:US
Practice Address - Phone:410-730-8780
Practice Address - Fax:410-730-8781
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD522061855OtherTAX ID # FOR PC
MDNATIONAL CAPITALBXBSOtherNATIONALCAPITALPROV#
MDBLUECROSSBLUESHIELDOtherSOCIALWORKPROVIDER#
MD4561201-00Medicaid
MDQ193NJMedicare ID - Type UnspecifiedSOCIAL WORK PROVIDER #