Healthcare Provider Details
I. General information
NPI: 1265573000
Provider Name (Legal Business Name): SUSAN ELAINE ALEXANDER, PH.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
134 MAIN ST SUITE 2C
FLEMINGTON NJ
08822-1652
US
IV. Provider business mailing address
134 MAIN ST SUITE 2C
FLEMINGTON NJ
08822-1652
US
V. Phone/Fax
- Phone: 908-788-7889
- Fax: 908-788-0840
- Phone: 908-788-7889
- Fax: 908-788-0840
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | SI03384 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | SI00384 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
SUSAN
ELAINE
ALEXANDER
Title or Position: OWNER,SOLE PROPRIETER
Credential: PH.D.
Phone: 908-788-7889