Provider Demographics
NPI:1992198717
Name:KROSNER, ALEXANDRA (LGSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KROSNER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 STEARNS HILL RD
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-3322
Mailing Address - Country:US
Mailing Address - Phone:301-461-2705
Mailing Address - Fax:
Practice Address - Street 1:175 ANDOVER ST
Practice Address - Street 2:#203
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-5311
Practice Address - Country:US
Practice Address - Phone:301-461-2705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19140104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker