Provider Demographics
NPI:1811514052
Name:CARPINELLI, ALEXA-RAE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ALEXA-RAE
Middle Name:
Last Name:CARPINELLI
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:ALEXA-RAE
Other - Middle Name:
Other - Last Name:FABIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 HEATH RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1010
Mailing Address - Country:US
Mailing Address - Phone:978-210-9474
Mailing Address - Fax:
Practice Address - Street 1:289 GREAT RD # G1
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4766
Practice Address - Country:US
Practice Address - Phone:978-679-1200
Practice Address - Fax:978-486-4037
Is Sole Proprietor?:No
Enumeration Date:2020-07-04
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289530163W00000X
MA2289530363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA020860Medicaid