Healthcare Provider Details

I. General information

NPI: 1457806051
Provider Name (Legal Business Name): ALEXANDRA HUNT LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 WASHINGTON ST
WEST WARWICK RI
02893-5017
US

IV. Provider business mailing address

100 BULLOCKS POINT AVE
RIVERSIDE RI
02915-5351
US

V. Phone/Fax

Practice location:
  • Phone: 401-864-0107
  • Fax:
Mailing address:
  • Phone: 401-437-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW02771
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: