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General NPI Number Information
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NPI Number | 1154899185
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Entity Type | Individual
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Provider Name | ALEXANDRA RUTH WILT LCSW, LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 9689 CARPENTER RD
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City | MILAN
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State | MI
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Zip | 48160-9547
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Country | US
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Telephone | 513-490-1286
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Fax |
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Provider Business Mailing Address
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Address Line | 12 E 44TH ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10017-3624
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Country | US
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Telephone | 513-490-1286
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 093039
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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 | I.2405506
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 105334
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW21033
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC06178700
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801117122
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License Number State | MI
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