Healthcare Provider Details

I. General information

NPI: 1124480785
Provider Name (Legal Business Name): ALEXANDRA HERNANDEZ-YSASI LICSW, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3859 37TH AVE S
SEATTLE WA
98118-1101
US

IV. Provider business mailing address

3859 37TH AVE S
SEATTLE WA
98118-1101
US

V. Phone/Fax

Practice location:
  • Phone: 914-815-5057
  • Fax:
Mailing address:
  • Phone: 914-815-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61065566
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC60876102
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: