Provider Demographics
NPI:1710418611
Name:ALEXANDER, ANGELIA NASHA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:NASHA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 W ROME BLVD APT 1018
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-2112
Mailing Address - Country:US
Mailing Address - Phone:702-801-5949
Mailing Address - Fax:702-543-7977
Practice Address - Street 1:3925 NORTH MARTIN LUTHER KING BLVD
Practice Address - Street 2:SUITE 119
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7848
Practice Address - Country:US
Practice Address - Phone:702-258-0031
Practice Address - Fax:702-221-0103
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NV8855-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1710418611Medicaid