Provider Demographics
NPI:1801514864
Name:MACCHIA, ALEXANDRA MARIE
Entity type:Individual
Prefix:
First Name:ALEXANDRA MARIE
Middle Name:
Last Name:MACCHIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 SPRINGBANK LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3346
Mailing Address - Country:US
Mailing Address - Phone:631-742-0968
Mailing Address - Fax:
Practice Address - Street 1:128 CARLETON AVE
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1804
Practice Address - Country:US
Practice Address - Phone:631-742-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19816101YM0800X
SC8741101YM0800X
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health