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General NPI Number Information
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NPI Number | 1629499413
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Entity Type | Individual
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Provider Name | BLONDINE ALEXANDRE LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 14300 GALLANT FOX LN STE 107
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City | BOWIE
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State | MD
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Zip | 20715-4031
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Country | US
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Telephone | 202-830-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 915 GREEN ST APT 2
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4046
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Country | US
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Telephone | 301-728-0371
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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 | 16313
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 16313
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50081199
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License Number State | DC
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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 | 0904011115
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License Number State | VA
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