Healthcare Provider Details

I. General information

NPI: 1407767858
Provider Name (Legal Business Name): SARAH CATHERINE ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S 17TH ST STE 300
PHILADELPHIA PA
19103-6204
US

IV. Provider business mailing address

1720 LOMBARD ST APT 503
PHILADELPHIA PA
19146-1574
US

V. Phone/Fax

Practice location:
  • Phone: 267-389-0052
  • Fax:
Mailing address:
  • Phone: 501-772-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW144741
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: