Healthcare Provider Details

I. General information

NPI: 1972407591
Provider Name (Legal Business Name): JOSHUA LAMONT ALEXANDER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W WESLEY DR
O FALLON IL
62269-1147
US

IV. Provider business mailing address

208 W WESLEY DR
O FALLON IL
62269-1147
US

V. Phone/Fax

Practice location:
  • Phone: 314-745-3520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2025005694
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: