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NPI Code Detail

MEDICARE: MRS. ALEXANDRA MAE DODGE LCSW

MEDICARE: MRS. ALEXANDRA MAE DODGE 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
11041C0700XClinical Social Worker1142904MA

General Provider Information

NPI Number : 1730967134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALEXANDRA MAE DODGE LCSW
Provider Business Mailing Address
First Line : 12 SPENCER ST
Second Line :
City : STONEHAM
State : MA
Zip : 02180-2616
Country : US
Telephone Number : 978-886-2739
Fax Number :
Provider Business Practice Location Address
First Line : 800 DISTRICT AVE STE 520
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-5060
Country : US
Telephone Number : 978-886-2739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2023
Last Update Date : 05/13/2026

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Directions to “ MRS. ALEXANDRA MAE DODGE LCSW” Practice Location

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