Healthcare Provider Details

I. General information

NPI: 1083548903
Provider Name (Legal Business Name): VANESSA CHRISTINE ALEXIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 MCDONOGH RD STE 208
OWINGS MILLS MD
21117-5469
US

IV. Provider business mailing address

3817 MONUMENT CIR APT 3A
ABINGDON MD
21009-2098
US

V. Phone/Fax

Practice location:
  • Phone: 410-559-6121
  • Fax: 916-581-8678
Mailing address:
  • Phone: 410-559-6121
  • Fax: 916-581-8678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number31347
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: