Provider Demographics
NPI:1811641491
Name:DEARLOVE, ALEXANDRA PAGE (LMSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PAGE
Last Name:DEARLOVE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E BROOKS ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2363
Mailing Address - Country:US
Mailing Address - Phone:810-280-1768
Mailing Address - Fax:
Practice Address - Street 1:7124 W GRAND RIVER RD STE 1
Practice Address - Street 2:
Practice Address - City:FOWLERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48836-8579
Practice Address - Country:US
Practice Address - Phone:517-258-1429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011140061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical