Provider Demographics
NPI:1669043519
Name:SHOBEN, ALYXANDRA NICOLE (LSW)
Entity type:Individual
Prefix:MISS
First Name:ALYXANDRA
Middle Name:NICOLE
Last Name:SHOBEN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MISS
Other - First Name:ALYX
Other - Middle Name:
Other - Last Name:SHOBEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2024 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15135-3002
Mailing Address - Country:US
Mailing Address - Phone:412-706-0447
Mailing Address - Fax:
Practice Address - Street 1:523 RAVINE ST
Practice Address - Street 2:
Practice Address - City:DRAVOSBURG
Practice Address - State:PA
Practice Address - Zip Code:15034-1012
Practice Address - Country:US
Practice Address - Phone:412-896-5140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137711104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker