Healthcare Provider Details

I. General information

NPI: 1538273768
Provider Name (Legal Business Name): ALEXANDRA H. OSTERMAN MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA H. SMITH LICSW

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 11/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BANK ROW ST FL 3
GREENFIELD MA
01301-3599
US

IV. Provider business mailing address

925 CONWAY RD
ASHFIELD MA
01330-9772
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-6252
  • Fax: 413-773-0477
Mailing address:
  • Phone: 413-774-6252
  • Fax: 413-773-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111-323
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: