Healthcare Provider Details

I. General information

NPI: 1831531128
Provider Name (Legal Business Name): ALEXANDRA ANN GREENE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA ANN DISCEPOLO

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 WHITFIELD ST
GUILFORD CT
06437-3429
US

IV. Provider business mailing address

119 MONTOWESE ST
BRANFORD CT
06405-3807
US

V. Phone/Fax

Practice location:
  • Phone: 203-208-9854
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number009754
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: