Provider Demographics
NPI:1679159867
Name:CARTER-HUFFMAN, ALEXANDRA L (LMSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:L
Last Name:CARTER-HUFFMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 FAWN RDG
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-9530
Mailing Address - Country:US
Mailing Address - Phone:315-380-6771
Mailing Address - Fax:
Practice Address - Street 1:1790 BROADWAY FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1427
Practice Address - Country:US
Practice Address - Phone:646-583-5960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111100561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical