Healthcare Provider Details

I. General information

NPI: 1396649885
Provider Name (Legal Business Name): ALEXANDRIA ADRIANA JACOBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 MAIN ST STE 2
WOONSOCKET RI
02895-4368
US

IV. Provider business mailing address

795 TURNPIKE ST
NORTH ANDOVER MA
01845-6128
US

V. Phone/Fax

Practice location:
  • Phone: 401-999-8181
  • Fax:
Mailing address:
  • Phone: 978-857-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW04631
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: