MEDICARE: HARRISON ALEXANDER WEST

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	0904017796	VA
2	1041C0700X	Clinical Social Worker	LG50082342	DC
3	1041C0700X	Clinical Social Worker	25551	MD

General Provider Information

NPI Number	:	1720671399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRISON ALEXANDER WEST

Provider Business Mailing Address
First Line	:	7229 G ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1870
Country	:	US
Telephone Number	:	301-778-4737
Fax Number	:

Provider Business Practice Location Address
First Line	:	7229 G ST
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-1870
Country	:	US
Telephone Number	:	301-778-4737
Fax Number	:

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

Provider Enumeration Date	:	02/15/2021
Last Update Date	:	04/15/2026

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