MEDICARE: ALEXANDRA N UMSTEAD LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C004466	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518008572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA N UMSTEAD LCSW

Provider Business Mailing Address
First Line	:	3904 OLEANDER DR
Second Line	:	SUITE 101
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6717
Country	:	US
Telephone Number	:	910-790-9500
Fax Number	:	910-796-8111

Provider Business Practice Location Address
First Line	:	3904 OLEANDER DR
Second Line	:	SUITE 101
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6717
Country	:	US
Telephone Number	:	910-790-9500
Fax Number	:	910-796-8111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	06/25/2012

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