Provider Demographics
NPI:1952836660
Name:ALEXANDER-SSEBAGALA, THERESE (LCSW)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:ALEXANDER-SSEBAGALA
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 1:21 PROVIDENCE CT
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4711
Mailing Address - Country:US
Mailing Address - Phone:860-650-0053
Mailing Address - Fax:508-433-1871
Practice Address - Street 1:554 LONG HILL RD STE 8
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4170
Practice Address - Country:US
Practice Address - Phone:860-650-0053
Practice Address - Fax:508-433-1871
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical