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General NPI Number Information
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NPI Number | 1053371195
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Entity Type | Individual
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Provider Name | ALEXANDER A. WILSON L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 01/01/2025
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Provider Practice Location Address
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Address Line | 7494 LEE DAVIS RD STE 16D
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-3607
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Country | US
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Telephone | 804-559-4566
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Fax | 804-559-1449
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Provider Business Mailing Address
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Address Line | PO BOX 292
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City | STUDLEY
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State | VA
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Zip | 23162-0292
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Country | US
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Telephone | 804-559-4566
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Fax | 804-559-1449
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0904001692
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License Number State | VA
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