Healthcare Provider Details

I. General information

NPI: 1770169906
Provider Name (Legal Business Name): ALEXANDRA WERNTZ CZYWCZYNSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA WERNTZ CZYWCZYNSKI PHD

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 OLYMPIA CIR STE 103
CHARLOTTESVILLE VA
22911-3614
US

IV. Provider business mailing address

1641 STONEY CREEK DR
CHARLOTTESVILLE VA
22902-7237
US

V. Phone/Fax

Practice location:
  • Phone: 703-517-6243
  • Fax:
Mailing address:
  • Phone: 703-517-6243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810007407
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: