Provider Demographics
NPI:1780719328
Name:ALEXIS, DARCIE A (LCSW)
Entity type:Individual
Prefix:
First Name:DARCIE
Middle Name:A
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DARCIE
Other - Middle Name:
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:848 SHERWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807
Mailing Address - Country:US
Mailing Address - Phone:973-214-2750
Mailing Address - Fax:
Practice Address - Street 1:45 RIVER RD STE 4
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-1452
Practice Address - Country:US
Practice Address - Phone:973-214-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW013329001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052463Medicare ID - Type Unspecified