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General NPI Number Information
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NPI Number | 1497402325
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Entity Type | Individual
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Provider Name | ALEXANDRA NIEVES PAGAN MSW
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Gender | Female
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 3840 5TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-7521
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Country | US
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Telephone | 727-367-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 775 NEWTON AVE S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-5323
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Country | US
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Telephone | 239-677-0457
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-205999
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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