Provider Demographics
NPI:1659705713
Name:LEMISZKI, ALEXANDER MICHAEL (MA, PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:MICHAEL
Last Name:LEMISZKI
Suffix:
Gender:M
Credentials:MA, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SHERMAN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-1214
Mailing Address - Country:US
Mailing Address - Phone:508-397-5689
Mailing Address - Fax:
Practice Address - Street 1:6 SHERMAN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1214
Practice Address - Country:US
Practice Address - Phone:508-397-5689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10791103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical