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General NPI Number Information
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NPI Number | 1124615364
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Entity Type | Individual
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Provider Name | ALEXIS HIGUERA AMBRIZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 344 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3923
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Country | US
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Telephone | 516-538-2613
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Fax |
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Provider Business Mailing Address
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Address Line | 344 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3923
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Country | US
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Telephone | 516-538-2613
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Fax |
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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 | 110476-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 100522
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License Number State | NY
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