Healthcare Provider Details

I. General information

NPI: 1255124459
Provider Name (Legal Business Name): ALEXANDRA LEWIS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 DERBY ST
HINGHAM MA
02043-4007
US

IV. Provider business mailing address

129 G ST APT 3
SOUTH BOSTON MA
02127-3452
US

V. Phone/Fax

Practice location:
  • Phone: 781-424-8119
  • Fax:
Mailing address:
  • Phone: 802-999-7069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: