Provider Demographics
NPI:1205426350
Name:ALEXANDRA BARTH LCSW, PLLC
Entity type:Organization
Organization Name:ALEXANDRA BARTH LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-929-0375
Mailing Address - Street 1:135 W ILLINOIS AVE UNIT 115
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-5808
Mailing Address - Country:US
Mailing Address - Phone:910-929-0375
Mailing Address - Fax:910-849-3633
Practice Address - Street 1:135 W ILLINOIS AVE UNIT 115
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5808
Practice Address - Country:US
Practice Address - Phone:910-929-0375
Practice Address - Fax:910-849-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health