Provider Demographics
NPI:1023331063
Name:JENNINGS, ALEXANDER JR (LCSW CAP)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:JENNINGS
Suffix:JR
Gender:M
Credentials:LCSW CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 SW 145TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7049
Mailing Address - Country:US
Mailing Address - Phone:305-634-3409
Mailing Address - Fax:305-635-3524
Practice Address - Street 1:20295 NW 2ND AVE STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2552
Practice Address - Country:US
Practice Address - Phone:305-974-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW96641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical