Provider Demographics
NPI:1255757449
Name:RICH, ALEXANDREA NICOLE (MARS, MSW, LGSW)
Entity type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:NICOLE
Last Name:RICH
Suffix:
Gender:F
Credentials:MARS, MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 LAUREL FORT MEADE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2040
Mailing Address - Country:US
Mailing Address - Phone:301-490-3825
Mailing Address - Fax:
Practice Address - Street 1:3450 LAUREL FORT MEADE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2040
Practice Address - Country:US
Practice Address - Phone:301-490-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLG50080510104100000X
DC19406104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker