Provider Demographics
NPI:1821854837
Name:MCFADDEN, ALEXIS SUZANNE (LSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SUZANNE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346-0449
Mailing Address - Country:US
Mailing Address - Phone:181-467-6280
Mailing Address - Fax:
Practice Address - Street 1:3226 STATE ROUTE 257
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346-2434
Practice Address - Country:US
Practice Address - Phone:181-467-6280
Practice Address - Fax:814-676-2804
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141162104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker