Healthcare Provider Details

I. General information

NPI: 1740901107
Provider Name (Legal Business Name): TORI MARIE ALEXANDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 E LANSING DR
EAST LANSING MI
48823-7785
US

IV. Provider business mailing address

2670 ZION RD
RIVES JUNCTION MI
49277-9725
US

V. Phone/Fax

Practice location:
  • Phone: 517-812-9459
  • Fax:
Mailing address:
  • Phone: 517-812-9459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801122475
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: