Healthcare Provider Details

I. General information

NPI: 1093993370
Provider Name (Legal Business Name): MARVIN CAIN ALEXANDER PHD, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 K ST NW STE 400
WASHINGTON DC
20006-1711
US

IV. Provider business mailing address

1380 MONROE ST NW # 736
WASHINGTON DC
20010-3452
US

V. Phone/Fax

Practice location:
  • Phone: 870-822-1906
  • Fax:
Mailing address:
  • Phone: 870-822-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2467-C
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50081614
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: