Provider Demographics
NPI:1821615360
Name:JESTER, ALEXA C (LMSW)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:C
Last Name:JESTER
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 1:3755 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:MD
Mailing Address - Zip Code:21655-2316
Mailing Address - Country:US
Mailing Address - Phone:410-443-5611
Mailing Address - Fax:
Practice Address - Street 1:27993 SUBSTATION RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-2830
Practice Address - Country:US
Practice Address - Phone:410-479-1743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22066104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker