Provider Demographics
NPI:1023726841
Name:DESJARDINS, ALEXIS (LCSW)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DESJARDINS
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 1:222 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER JUNCTION
Mailing Address - State:RI
Mailing Address - Zip Code:02894-1007
Mailing Address - Country:US
Mailing Address - Phone:401-575-7873
Mailing Address - Fax:
Practice Address - Street 1:65 VILLAGE SQUARE DR STE 302
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-2569
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:401-941-7847
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW032551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical