Provider Demographics
NPI:1710466099
Name:RICHARDS, ALEXANDRA B (LCSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:B
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:B
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:222 S MERAMEC AVE STE 202-1081
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1805
Mailing Address - Country:US
Mailing Address - Phone:314-704-0753
Mailing Address - Fax:
Practice Address - Street 1:222 S MERAMEC AVE STE 202-1081
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1805
Practice Address - Country:US
Practice Address - Phone:314-704-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017018454104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker