Healthcare Provider Details

I. General information

NPI: 1013710748
Provider Name (Legal Business Name): ALEXANDRA ESPOSITO M.ED., LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 FARNSWORTH AVE
BORDENTOWN NJ
08505-1709
US

IV. Provider business mailing address

36 BRAINERD ST
MOUNT HOLLY NJ
08060-1871
US

V. Phone/Fax

Practice location:
  • Phone: 609-200-5598
  • Fax:
Mailing address:
  • Phone: 609-410-0633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00857300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: