Healthcare Provider Details

I. General information

NPI: 1235061060
Provider Name (Legal Business Name): ALEXA RAYMUNDO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WASHINGTON AVE
HALETHORPE MD
21227-3115
US

IV. Provider business mailing address

4119 SPRINGSLEIGH RD
RANDALLSTOWN MD
21133-2031
US

V. Phone/Fax

Practice location:
  • Phone: 667-600-3984
  • Fax:
Mailing address:
  • Phone: 667-324-7499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34060
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: