Provider Demographics
NPI:1629615372
Name:SCHUTTE, ALEXANDRA LEIGH (MHC-LP)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:LEIGH
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HANOVER SQ APT 4HG
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2615
Mailing Address - Country:US
Mailing Address - Phone:908-692-3496
Mailing Address - Fax:
Practice Address - Street 1:301 W 140TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1406
Practice Address - Country:US
Practice Address - Phone:646-668-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102614-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health