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General NPI Number Information
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NPI Number | 1912376070
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Entity Type | Individual
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Provider Name | ALEXANDRA J D'ERRICO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 90 W MAIN ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2144
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Country | US
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Telephone | 718-614-4792
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Fax |
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Provider Business Mailing Address
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Address Line | 315 ROUTE 34 STE 106
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City | COLTS NECK
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State | NJ
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Zip | 07722-2443
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Country | US
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Telephone | 718-614-4792
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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 | 44SC05944200
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License Number State | NJ
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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 | 44SL06085900
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License Number State | NJ
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